Surgical stapling system comprising an end effector including an anvil with an anvil cap

ABSTRACT

A surgical stapling system comprising an end effector, a firing assembly, a motorized system, an elongate shaft, and a handle assembly is disclosed. The end effector is configurable in an open configuration and a closed configuration and comprises an elongate channel, an anvil, and a staple cartridge including a plurality of staples removably stored therein. The firing assembly is movable from a starting position toward an ending position during a firing stroke. The staples are deployable from the staple cartridge based on the firing assembly moving toward the ending position. The motorized system is configured to drive the firing assembly toward the ending position. The anvil comprises an anvil body and an anvil cap welded to the anvil body. The anvil cap is configured to increase a stiffness of the anvil.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. § 120 to U.S. patent application Ser. No. 15/793,575, entitledSURGICAL CUTTING AND STAPLING METHODS, filed Oct. 25, 2017, which issuedon Jun. 8, 2021 as U.S. Pat. No. 11,026,677, which is a continuationapplication claiming priority under 35 U.S.C. § 120 to U.S. patentapplication Ser. No. 14/138,516, entitled SURGICAL CUTTING AND STAPLINGMETHODS, filed Dec. 23, 2013, now U.S. Patent Application PublicationNo. 2015/0173756, the entire disclosures of which are herebyincorporated by reference herein.

BACKGROUND

The present invention relates to surgical instruments and, in variousembodiments, to surgical cutting and stapling instruments and staplecartridges therefor that are designed to cut and staple tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

The various features and advantages of this invention and the manner ofattaining them will become more apparent and the invention itself willbe better understood by reference to the following description ofembodiments of the invention taken in conjunction with the accompanyingdrawings, wherein:

FIG. 1 is a perspective view of one surgical instrument arrangement;

FIG. 2 is an enlarged perspective view of an end effector and a portionof the elongated shaft assembly of the surgical instrument of FIG. 1 ;

FIG. 3 is an exploded perspective view of the end effector and portionof the elongated shaft assembly of FIGS. 1 and 2 ;

FIG. 4 is a perspective view of a portion of a distal anvil portion ofthe end effector of FIGS. 2 and 3 ;

FIG. 5 is a lower perspective view of a proximal anvil mounting tubearrangement of the end effector of FIGS. 2 and 3 ;

FIG. 6 is an elevational view of the distal end of the proximal anvilmounting tube of FIG. 5 ;

FIG. 7 is an end cross-sectional view of the distal anvil portion andproximal anvil mounting tube assembled together;

FIG. 8 is an exploded perspective assembly view of a portion of thehandle assembly of the surgical instrument of FIG. 1 ;

FIG. 9 is another perspective view of the end effector and elongatedshaft assembly of FIG. 2 with the anvil assembly in an open position;

FIG. 10 is a perspective view of portions of the elongated shaftassembly, articulation system and firing system of the surgicalinstrument of FIG. 1 ;

FIG. 11 is a side view of a portion of the articulation system of thesurgical instrument of FIG. 1 with portions thereof shown incross-section;

FIG. 12 is a cross-sectional view of the end effector and elongatedshaft assembly portion of FIGS. 2 and 9 with the anvil assembly in aclosed, but unfired position;

FIG. 13 is a cross-sectional view of the end effector and elongatedshaft assembly portion of FIGS. 2, 9 and 12 in an articulated positionand after the cutting head assembly has been retracted to a startingposition after being fired;

FIG. 14 is a partial perspective view of the end effector and portion ofthe elongated shaft assembly after the cutting head assembly has beenretracted to a starting position after being fired;

FIG. 15 is a partial perspective view of an another end effector andelongated shaft assembly with the end effector in a closed position;

FIG. 16 is a cross-sectional perspective view of the end effector andelongated shaft assembly of FIG. 15 ;

FIG. 17 is an exploded perspective assembly view of the end effector andelongated shaft assembly of FIGS. 15 and 16 ;

FIG. 18 is a cross-sectional perspective view of the end effector andelongated shaft assembly of FIGS. 15-17 ;

FIG. 19 is an exploded perspective assembly view of a handle assemblyportion of a surgical instrument;

FIG. 20 is a perspective view of another surgical instrument;

FIG. 21 is a partial perspective view of the end effector of thesurgical instrument of FIG. 20 in a closed position;

FIG. 22 is a cross-sectional perspective view of the end effector ofFIG. 21 ;

FIG. 23 is an exploded perspective assembly view of the end effector ofFIGS. 21 and 22 ;

FIG. 24 is a cross-sectional elevational view of the end effector ofFIGS. 21-23 with the anvil assembly thereof in an open position;

FIG. 25 is another cross-sectional view of the end effector of FIGS.21-24 in an articulated position and with the anvil assembly thereof inan open position;

FIG. 26 is another cross-sectional view of the end effector of FIG. 24after the anvil has been closed onto tissue;

FIG. 27 is a perspective view of another surgical instrument;

FIG. 28 is a partial perspective view of the end effector of thesurgical instrument of FIG. 27 in a closed position;

FIG. 29 is an exploded perspective assembly view of the end effector andelongated shaft assembly of FIGS. 27 and 28 ;

FIG. 30 is a cross-sectional perspective view of the end effector ofFIGS. 28 and 29 ;

FIG. 31 is a cross-sectional side view of the end effector of FIGS.28-30 with the anvil assembly thereof in a closed position;

FIG. 32 is another cross-sectional side view of the end effector ofFIGS. 28-31 with the anvil assembly thereof in an open position;

FIG. 33 is a cross-sectional side view of the end effector of FIGS.28-32 in an articulated position and with the anvil assembly thereof inan open position;

FIG. 34 is a perspective assembly view of portions of the articulationsystem and firing system of the surgical instrument of FIG. 27 ;

FIG. 35 is a side view of a portion of the articulation system of FIG.34 with portions thereof shown in cross-section;

FIG. 36 is a perspective view of another surgical instrument;

FIG. 37 is a partial perspective view of the end effector of thesurgical instrument of FIG. 36 in a closed position;

FIG. 38 is a distal exploded perspective assembly view of the endeffector and elongated shaft assembly of FIGS. 36 and 37 ;

FIG. 39 is a proximal exploded perspective assembly view of the endeffector and elongated shaft assembly of FIGS. 36-38 ;

FIG. 40 is a cross-sectional end view of a portion of the end effectorof FIGS. 36-39 ;

FIG. 41 is a partial perspective view of portions of the end effector ofFIGS. 36-40 with the anvil assembly thereof in an open position;

FIG. 42 is another partial perspective view of portions of the endeffector of FIGS. 36-41 with the anvil assembly thereof in an openposition;

FIG. 43 is a partial side view of a cutting beam head in itsuncompressed state;

FIG. 44 is another partial side view of the cutting beam head of FIG. 43in its maximum compressed state;

FIG. 45 is a cross-sectional end view of an end effector and a cuttingbeam head of FIGS. 43 and 44 in its maximum compressed state;

FIG. 46 is another cross-sectional view of the end effector and cuttingbeam head of FIG. 45 after the end effector has cut and stapled tissue;

FIG. 47 is a perspective view of another surgical instrument;

FIG. 48 is an exploded perspective view of another surgical end effectorof the present invention;

FIG. 49 is an exploded assembly view of the handle assembly of thesurgical instrument of FIG. 47 ;

FIG. 50 is an exploded assembly view of an elongated shaft assembly ofthe surgical instrument of FIGS. 47-49 ;

FIG. 51 is a cross-sectional side view of a portion of the surgicalinstrument of FIGS. 47-50 inserted through a portion of a trocar port;

FIG. 52 is another cross-sectional side view of the surgical instrumentof FIG. 51 after it has exited through the trocar port inside thepatient;

FIG. 53 is another cross-sectional side view of the surgical instrumentof FIGS. 51 and 52 after the anvil assembly has been moved to an openposition;

FIG. 54 is another cross-sectional side view of the surgical instrumentof FIGS. 51-53 with the anvil in the closed firing position;

FIG. 55 is a cross-sectional side view of a portion of another surgicalinstrument inserted through a portion of a trocar port;

FIG. 56 is another cross-sectional side view of the surgical instrumentof FIG. 55 after the end effector has passed through the trocar portinto the patient;

FIG. 57 is a perspective view of one form of a control insert;

FIG. 58 is a cross-sectional side view of a portion of another endeffector inserted through a portion of a trocar port;

FIG. 59 is another cross-sectional side view of the end effector of FIG.58 exiting the trocar port;

FIG. 60 is a cross-sectional view of another end effector arrangement;

FIG. 61 is a cross-sectional view of another end effector arrangement;

FIG. 62 is a cross-sectional side view of a portion of another endeffector and distal closure tube arrangement wherein a portion of theend effector is inserted through a portion of a trocar port;

FIG. 63 is another cross-sectional side view of the end effector of FIG.62 exiting the trocar port;

FIG. 64 is a perspective view of one form of a surgical instrument ofthe present invention;

FIG. 65 is an exploded perspective view of one form of surgical endeffector of the present invention;

FIG. 66 is an exploded perspective view of a portion of the surgicalinstrument of FIG. 64 ;

FIG. 67 is an exploded perspective assembly view of another portion ofthe surgical instrument of FIG. 64 ;

FIG. 68 is an exploded perspective assembly view of a portion of theelongated shaft assembly of the surgical instrument of FIG. 64 ;

FIG. 69 is a perspective view of the surgical end effector of FIG. 65and a distal closure tube segment;

FIG. 70 is a rear perspective view of a portion of an anvil embodiment;

FIG. 70A is an exploded perspective assembly view of another surgicalend effector assembly;

FIG. 70B is a rear perspective view of a portion of another anvilassembly embodiment and another closure tube segment embodiment;

FIG. 70C is a perspective view of a portion of another anvil assemblyand another distal closure tube segment;

FIG. 70D is an exploded perspective assembly view of another surgicalend effector embodiment;

FIG. 70E is an exploded perspective assembly view of another surgicalend effector embodiment;

FIG. 71 is a side cross-sectional view of a surgical end effector anddistal closure tube segment with the anvil assembly in an open position;

FIG. 72 is another side cross-sectional view of the surgical endeffector and distal closure tube segment of FIG. 71 ;

FIG. 73 is a perspective view of a portion of the surgical instrument ofFIG. 64 with a portion of the handle housing removed;

FIG. 74 is a perspective view of a portion of a firing drive system;

FIG. 75 is a perspective view of an intermediate portion of an elongatedshaft assembly embodiment;

FIG. 76 is an elevational view of the distal end of the intermediateshaft portion of FIG. 75 ;

FIG. 77 is side elevational view of the intermediate shaft portion ofFIGS. 74 and 75 ;

FIG. 78 is a plan view of the intermediate shaft portion of FIGS. 74-77;

FIG. 79 is an enlarged side elevational view of portions of adjacentribs of the intermediate shaft portion of FIGS. 74-78 ;

FIG. 80 is a plan view of another intermediate shaft portion embodiment;

FIG. 81 is a side elevational view of the intermediate shaft portion ofFIG. 80 ;

FIG. 82 is a cross-sectional plan view of the intermediate shaft portionof FIGS. 80 and 81 articulated into a substantial U-shape;

FIG. 83 is a perspective view of one surgical instrument arrangement;

FIG. 84 is an exploded perspective assembly view of a surgical endeffector arrangement;

FIG. 85 is a side elevational view of an anvil;

FIG. 86 is a side cross-sectional view of an end effector and portion ofan elongated shaft assembly with the end effector shown in anunarticulated position in solid lines and the end effector shown inarticulated positions in broken lines;

FIG. 87 is another side cross-sectional view of an end effector andportion of an elongated shaft assembly with the anvil in a closedposition and the cutting head in an end position after being fireddistally through the staple cartridge;

FIG. 88 is another side cross-sectional view of the end effector andelongated shaft assembly portion of FIG. 87 after the cutting head hasbeen retracted proximally back to its starting position;

FIG. 89 is another side cross-sectional view of an end effector andportion of an elongated shaft assembly with the anvil in an openposition and the cutting head in a starting position;

FIG. 90 is an enlarged cross-sectional view of the end effector andportion of the elongated shaft assembly of FIG. 89 ;

FIG. 91 is a cross-sectional perspective view of the end effector andportion of the elongated shaft assembly of FIG. 89 ;

FIG. 92 is a perspective assembly view of an end effector and elongatedshaft assembly;

FIG. 93 is a cross-sectional view of a distal portion of an elongatedshaft assembly;

FIG. 94 is a cross-sectional view of a proximal portion of the elongatedshaft assembly of FIG. 11 along with a portion of an articulationsystem;

FIG. 95 is a perspective view of an elongated shaft assembly and endeffector;

FIG. 96 is a partial perspective exploded view of a handle assembly;

FIG. 97 is a perspective view of a surgical instrument arrangement ofthe present invention;

FIG. 98 is a perspective view of an exemplary loading unit that may beemployed in connection with various surgical instruments disclosedherein;

FIG. 99 is another partial cross-sectional view of a portion of theloading unit depicted in FIG. 98 ;

FIG. 100 is an exploded perspective view of the loading unit of FIGS. 98and 99 ;

FIG. 101 is a partial perspective view of a portion of a carrier and anarticulation ball assembly embodiment;

FIG. 102 is a perspective view of an articulation tube embodiment;

FIG. 103 is a partial cross-sectional view of a loading unit of FIGS.98-100 ;

FIG. 104 is another cross-sectional view of the loading unit of FIG. 103in an unarticulated position;

FIG. 105 is another cross-sectional view of the loading unit of FIGS.103 and 104 with the carrier and anvil assembly articulated as a unit ina second direction;

FIG. 106 is a partial perspective view of a loading unit and a portionof an elongated shaft assembly prior to commencing a coupling operationbetween the loading unit and a distal end of the elongated shaftassembly;

FIG. 107 is another perspective view of portions of the loading unit andelongated shaft assembly of FIG. 106 after being coupled together;

FIG. 108 is a partial exploded perspective view of portions of theelongated shaft assembly, a coupling assembly and the loading unit ofFIG. 106 ;

FIG. 109 is another partial exploded perspective view of the shaftassembly, the coupling assembly and the loading unit of FIG. 106 ;

FIG. 110 is a perspective view of a distal attachment portion of theloading unit of FIG. 106 ;

FIG. 111 is another perspective view of the distal attachment portion ofthe loading unit of FIG. 106 ;

FIG. 112 is a perspective view of a proximal attachment portion of theelongated shaft assembly of FIG. 109 ;

FIG. 113 is another perspective view of the proximal attachment portionof the elongated shaft assembly of FIG. 109 ;

FIG. 114 is a perspective view of the collar and a firing shaftarrangement;

FIG. 115 is a partial perspective, cross-section view of the loadingunit, the coupling assembly, and a proximal end of the elongated shaftassembly of FIG. 109 , depicting the loading unit attached to theelongated shaft assembly;

FIG. 116 is a partial elevation, cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit unattached to the elongated shaftassembly;

FIG. 117 is a partial elevation, cross-sectional view of the loadingunit, the coupling assembly and the elongated shaft assembly of FIG. 109, depicting the loading unit attached to the elongated shaft assembly;

FIG. 118 is an elevational view of the coupling assembly and theelongated shaft assembly of FIG. 109 taken along the plane indicated inFIG. 115 ;

FIG. 119 is a perspective, partial cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit unattached to the elongated shaftassembly, and further depicting the coupling collar in an initialorientation relative to the elongated shaft assembly;

FIG. 120 is a perspective, partial cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit unattached to the shaft, and furtherdepicting the coupling collar in the initial orientation relative to theelongated shaft assembly;

FIG. 121 is a perspective, partial cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit entering the elongated shaft assembly,and further depicting the coupling collar in the initial orientationrelative to the elongated shaft assembly;

FIG. 122 is a perspective, partial cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit entering the elongated shaft assembly,and further depicting the coupling collar in a secondary, rotatedorientation relative to the elongated shaft assembly;

FIG. 123 is a perspective, partial cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit entering the elongated shaft assembly,and further depicting the coupling collar in the secondary, rotatedorientation relative to the elongated shaft assembly;

FIG. 124 is a perspective, partial cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit fully inserted into the elongated shaftassembly, and further depicting the coupling collar in the secondary,rotated orientation relative to the elongated shaft assembly;

FIG. 125 is a perspective, partial cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit fully inserted into the elongated shaftassembly, and further depicting the coupling collar in the initialorientation relative to the elongated shaft assembly;

FIG. 126 is a perspective, partial cross-sectional view of the loadingunit, the coupling assembly, and the elongated shaft assembly of FIG.109 , depicting the loading unit fully inserted into the elongated shaftassembly, and further depicting the coupling collar in the initialorientation relative to the elongated shaft assembly;

FIG. 127 is a perspective view of a surgical instrument according tovarious embodiments of the present disclosure;

FIG. 128 is an exploded perspective view of a handle assembly of thesurgical instrument of FIG. 127 according to various embodiments of thepresent disclosure;

FIG. 129 is an exploded perspective view of an end effector of thesurgical instrument of FIG. 127 according to various embodiments of thepresent disclosure;

FIG. 130 is a perspective view of a staple cartridge of the end effectorof FIG. 129 according to various embodiments of the present disclosure;

FIG. 131 is a cross-sectional perspective view of the staple cartridgeof FIG. 130 taken along the plane indicated in FIG. 130 according tovarious embodiments of the present disclosure;

FIG. 132 is a perspective view of the staple depicted in the staplecartridge of FIG. 130 according to various embodiments of the presentdisclosure;

FIG. 133 is a front elevation view of the staple of FIG. 132 ;

FIG. 134 is a rear elevation view of the staple of FIG. 132 ;

FIG. 135 is a top plan view of the staple of FIG. 132 ;

FIG. 136 is a bottom plan view of the staple of FIG. 132 ;

FIG. 137 is a right elevation view of the staple of FIG. 132 ;

FIG. 138 is a left elevation view of the staple of FIG. 132 ;

FIG. 139 is a perspective view of the staple of FIG. 132 ;

FIG. 140 is an elevation view of the staple of FIG. 132 and a sled ofthe end effector of FIG. 129 , depicting a leading surface of the sledcontacting an initial drive surface of the staple, according to variousembodiments of the present disclosure;

FIG. 141 is a perspective view of the staple and the sled of FIG. 140 ,depicting the leading surface of the sled contacting the initial drivesurface of the staple;

FIG. 142 is an elevation view of the staple and the sled of FIG. 140 ,depicting a trailing surface of the sled contacting a secondary drivesurface of the staple, according to various embodiments of the presentdisclosure;

FIG. 143 is a perspective view of the staple and the sled of FIG. 140 ,depicting the trailing surface of the sled contacting the secondarydrive surface of the staple;

FIGS. 144-147 are cross-sectional elevation views of the end effector ofFIG. 129 , depicting a firing progression of staples from the staplecartridge, according to various embodiments of the present disclosure;

FIG. 148 is a cross-sectional elevation view of the staple cartridge andthe sleds of FIG. 129 , depicting the staples in unfired positions,according to various embodiments of the present disclosure;

FIG. 149 is a cross-sectional perspective view of the cartridge and thesleds of FIG. 148 , depicting the staples in the unfired positionsdepicted in FIG. 148 ;

FIG. 150 is a cross-sectional elevation view of the cartridge and thesleds of FIG. 148 , depicting a proximal pair of staples in partiallyfired positions and the remaining staples in unfired positions,according to various embodiments of the present disclosure;

FIG. 151 is a cross-sectional perspective view of the cartridge and thesleds of FIG. 148 , depicting the proximal pair of staples in thepartially fired positions depicted in FIG. 150 and the remaining staplesin the unfired positions depicted in FIG. 150 ;

FIG. 152 is a cross-sectional elevation view of the cartridge and thesleds of FIG. 148 , depicting multiple pairs of staples in partiallyfired positions and the proximal pair of staples in partially deformedconfigurations, according to various embodiments of the presentdisclosure;

FIG. 153 is a cross-sectional perspective view of the cartridge and thesleds of FIG. 148 , depicting the multiple pairs of staples in thepartially fired positions of FIG. 152 and the proximal pair of staplesin the partially deformed configurations depicted in FIG. 152 ;

FIG. 154 is a cross-sectional elevation view of the cartridge and thesleds of FIG. 148 , depicting multiple pairs of staples in further firedpositions and the proximal pair of staples in further deformedconfigurations, according to various embodiments of the presentdisclosure;

FIG. 155 is a cross-sectional perspective view of the cartridge and thesleds of FIG. 148 , depicting the multiple pairs of staples in thepartially fired positions depicted in FIG. 154 and the proximal pair ofstaples in the partially deformed configurations depicted in FIG. 154 ;

FIG. 156 is a cross-sectional elevation view of the cartridge and thesleds of FIG. 148 , depicting multiple pairs of staples in partiallyfired positions and in partially deformed configurations and theproximal pair of staples in ejected positions and in fully deformedconfigurations, according to various embodiments of the presentdisclosure;

FIG. 157 is a cross-sectional perspective view of the cartridge and thesleds of FIG. 148 , depicting the multiple pairs of staples in thepartially fired positions and in the partially deformed configurationsdepicted in FIG. 156 and the proximal pair of staples in the ejectedpositions and in the fully deformed configurations depicted in FIG. 156;

FIGS. 158A-158C illustrate a method for forming staples from a sheet ofmaterial according to various embodiments of the present disclosure;

FIG. 159 is a perspective view of the staple formed from the methoddepicted in FIGS. 158A-158C, according to various embodiments of thepresent disclosure;

FIG. 160 is a plan view of the staple of FIG. 159 ;

FIG. 161 is a front elevation view of the staple of FIG. 159 ;

FIG. 162 is a side elevation view of the staple of FIG. 159 ;

FIG. 163 is a perspective view of a staple according to variousembodiments of the present disclosure;

FIG. 164 is a plan view of the staple of FIG. 163 ;

FIG. 165 is a front elevation view of the staple of FIG. 163 ;

FIG. 166 is a side elevation view of the staple of FIG. 163 ;

FIG. 167 is a perspective view of a staple according to variousembodiments of the present disclosure;

FIG. 168 is a plan view of the staple of FIG. 167 ;

FIG. 169 is a front elevation view of the staple of FIG. 167 ;

FIG. 170 is a side elevation view of the staple of FIG. 167 ;

FIG. 171 is a perspective view of a staple cartridge according tovarious embodiments of the present disclosure;

FIG. 172 is a cross-sectional perspective view of the staple cartridgeof FIG. 171 taken along the plane indicated in FIG. 171 ;

FIG. 173 is a plan view of the staple cartridge of FIG. 171 ;

FIG. 174 is a perspective view of a staple according to variousembodiments of the present disclosure;

FIG. 175 is a plan view of the staple of FIG. 174 ;

FIG. 176 is a front elevation view of the staple of FIG. 174 ;

FIG. 177 is a side elevation view of the staple of FIG. 174 ;

FIG. 178 is a perspective view of a staple according to variousembodiments of the present disclosure;

FIG. 179 is a plan view of the staple of FIG. 178 ;

FIG. 180 is a front elevation view of the staple of FIG. 178 ;

FIG. 181 is a side elevation view of the staple of FIG. 178 ;

FIG. 182 is a partial, cross-sectional elevation view of the staplecartridge of FIG. 130 , depicting a staple in a partially-fired positionin a staple cavity, according to various embodiments of the presentdisclosure;

FIG. 183 is a partial plan view of the staple cartridge of FIG. 182 ,depicting the staple in the partially-fired position depicted in FIG.182 ;

FIG. 184 is a partial, cross-sectional elevation view of the staplecartridge of FIG. 182 , depicting the staple in the partially-firedposition depicted in FIG. 182 ;

FIG. 185 is a partial, cross-sectional elevation view of the staplecartridge of FIG. 182 , depicting the staple in another partially-firedposition, according to various embodiments of the present disclosure;

FIG. 186 is a partial, plan view of the staple cartridge of FIG. 182 ,depicting the staple in the partially-fired position depicted in FIG.185 ;

FIG. 187 is a partial, cross-sectional elevation view of the staplecartridge of FIG. 182 , depicting the staple in the partially-firedposition depicted in FIG. 185 ;

FIG. 188 is a partial, cross-sectional elevation view of the staplecartridge of FIG. 182 , depicting the staple in an ejected position andin a deformed configuration, according to various embodiments of thepresent disclosure;

FIG. 189 is a partial plan view of the staple cartridge of FIG. 182 ,depicting the staple in the ejected position and in the deformedconfiguration depicted in FIG. 188 ;

FIG. 190 is a partial, cross-sectional elevation view of the staplecartridge of FIG. 182 , depicting the staple in the ejected position andthe deformed configuration depicted in FIG. 188 ;

FIG. 191 is an exploded perspective view of an end effector comprising aplurality of fasteners and a firing actuator configured to eject thefasteners from the end effector according to various embodiments of thepresent disclosure;

FIG. 192 is a plan view of a first portion of the fastener firingactuator of FIG. 191 ;

FIG. 193 is an elevational view of the first portion of FIG. 192 ;

FIG. 194 is a plan view of a second portion of the fastener firingactuator of FIG. 191 ;

FIG. 195 is an elevational view of the second portion of FIG. 194 ;

FIG. 196 is a cross-sectional view of the end effector of FIG. 191illustrating the firing actuator in an unfired, unextended condition;

FIG. 197 is a cross-sectional view of the end effector of FIG. 191illustrating the firing actuator in an extended condition;

FIG. 198 is a cross-sectional view of the end effector of FIG. 191illustrating the firing actuator in an extended, advanced condition;

FIG. 199 is a cross-sectional view of the end effector of FIG. 191illustrating an anvil of the end effector in an open position and thefiring actuator in an unfired, unextended condition;

FIG. 200 is a cross-sectional view of the end effector of FIG. 191illustrating the anvil in a closed position and the firing actuator inan unfired, unextended condition;

FIG. 201 is a cross-sectional perspective view of the end effector ofFIG. 191 illustrated in the configuration depicted in FIG. 199 ;

FIG. 202 is a cross-sectional view of the end effector of FIG. 191illustrated in the configuration depicted in FIG. 200 ;

FIG. 203 is a cross-sectional view of the end effector of FIG. 191illustrating the firing actuator in an extended condition and, inaddition, a knife member in an unadvanced position;

FIG. 204 is a cross-sectional view of the end effector of FIG. 191illustrating the firing actuator in an advanced, extended condition andthe knife member in an advanced position;

FIG. 205 is a cross-sectional perspective view of the end effector ofFIG. 191 illustrated in the configuration depicted in FIG. 204 ;

FIG. 206 is a partial cross-sectional plan view of the end effector ofFIG. 191 illustrated in a fully-fired condition;

FIG. 207 is a cross-sectional elevational view of the end effector ofFIG. 191 illustrated in the configuration depicted in FIG. 206 ;

FIG. 208 is a cross-sectional perspective view of the end effector ofFIG. 191 illustrated in the configuration depicted in FIG. 206 ;

FIG. 209 is a cross-sectional elevational view of the end effector ofFIG. 191 illustrating the knife member in a retracted position;

FIG. 210 is a cross-sectional perspective view of the end effector ofFIG. 191 illustrated in the configuration depicted in FIG. 209 ;

FIG. 211 is a perspective view of the firing member of the end effectorof FIG. 191 illustrated in the unextended configuration depicted in FIG.200 ;

FIG. 212 is a perspective view of the firing member of the end effectorof FIG. 191 illustrated in the extended configuration depicted in FIG.203 ;

FIG. 213 is a perspective view of the firing member of the end effectorof FIG. 191 illustrated in a configuration just prior to the fully-firedconfiguration depicted in FIG. 206 ;

FIG. 214 is a perspective view of the firing member of the end effectorof FIG. 191 illustrated in the fully-fired configuration depicted inFIG. 206 ;

FIG. 215 is a cross-sectional view of an end effector including a firingactuator configured to eject fasteners from a fastener cartridgeillustrating the firing actuator in an unfired position;

FIG. 216 is a cross-sectional view of the end effector of FIG. 215illustrating the firing actuator in a partially fired position;

FIG. 217 is a plan view of a staple cartridge body of the end effectorof FIG. 215 ;

FIG. 218 is a perspective view of a firing actuator for use with thecartridge body of FIG. 217 ;

FIG. 219 is a perspective view of the cartridge body of FIG. 217 ; and

FIG. 220 is a cross-sectional view of the cartridge body of FIG. 217taken along line 220-220 in FIG. 219 .

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate preferred embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Applicant of the present application also owns the following patentapplications that were filed on Dec. 23, 2013 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 14/138,465, entitled SURGICAL        STAPLES AND STAPLE CARTRIDGES, now U.S. Pat. No. 10,265,065;    -   U.S. patent application Ser. No. 14/138,475, entitled SURGICAL        STAPLES AND STAPLE CARTRIDGES, now U.S. Patent Application        Publication No. 2015/0173749:    -   U.S. patent application Ser. No. 14/138,481, entitled SURGICAL        STAPLES AND METHODS FOR MAKING THE SAME, now U.S. Pat. No.        9,968,354;    -   U.S. patent application Ser. No. 14/138,489, entitled SURGICAL        STAPLES, STAPLE CARTRIDGES AND SURGICAL END EFFECTORS, now U.S.        Pat. No. 9,687,232;    -   U.S. Design patent application Serial No. 29/477,488, entitled        SURGICAL FASTENER, now U.S. Pat. No. D775,336;    -   U.S. patent application Ser. No. 14/138,505, entitled FASTENER        CARTRIDGE COMPRISING AN EXTENDABLE FIRING MEMBER, now U.S. Pat.        No. 9,585,662;    -   U.S. patent application Ser. No. 14/138,518, entitled FASTENER        CARTRIDGE COMPRISING A FIRING MEMBER CONFIGURED TO DIRECTLY        ENGAGE AND EJECT FASTENERS FROM THE FASTENER CARTRIDGE, now U.S.        Pat. No. 9,763,662;    -   U.S. patent application Ser. No. 14/138,530, entitled FASTENER        CARTRIDGE COMPRISING A FIRING MEMBER INCLUDING FASTENER        SURFACES, now U.S. Pat. No. 9,549,735;    -   U.S. patent application Ser. No. 14/138,554, entitled SURGICAL        INSTRUMENTS WITH ARTICULATABLE SHAFT ARRANGEMENTS, now U.S.        Patent Application Publication No. 2015/0173789;    -   U.S. patent application Ser. No. 14/138,474, entitled        ARTICULATABLE SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCT        CLOSING AND FIRING SYSTEMS, now U.S. Pat. No. 9,681,870;    -   U.S. patent application Ser. No. 14/138,485, entitled SURGICAL        CUTTING AND STAPLING INSTRUMENTS WITH INDEPENDENT JAW CONTROL        FEATURES, now U.S. Pat. No. 9,839,428;    -   U.S. patent application Ser. No. 14/138,497, entitled SURGICAL        CUTTING AND STAPLING INSTRUMENTS WITH ARTICULATABLE END        EFFECTORS, now U.S. Pat. No. 9,642,620; and    -   U.S. patent application Ser. No. 14/138,507, entitled MODULAR        SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,724,092.

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those of ordinary skill in the art will understand that thedevices and methods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the various embodiments of the present invention is definedsolely by the claims. The features illustrated or described inconnection with one exemplary embodiment may be combined with thefeatures of other embodiments. Such modifications and variations areintended to be included within the scope of the present invention.

Reference throughout the specification to “various embodiments,” “someembodiments,” “one embodiment,” or “an embodiment”, or the like, meansthat a particular feature, structure, or characteristic described inconnection with the embodiment is included in at least one embodiment.Thus, appearances of the phrases “in various embodiments,” “in someembodiments,” “in one embodiment”, or “in an embodiment”, or the like,in places throughout the specification are not necessarily all referringto the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments. Thus, the particular features, structures, orcharacteristics illustrated or described in connection with oneembodiment may be combined, in whole or in part, with the featuresstructures, or characteristics of one or more other embodiments withoutlimitation. Such modifications and variations are intended to beincluded within the scope of the present invention.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” referring to the portion closest to the clinicianand the term “distal” referring to the portion located away from theclinician. It will be further appreciated that, for convenience andclarity, spatial terms such as “vertical”, “horizontal”, “up”, and“down” may be used herein with respect to the drawings. However,surgical instruments are used in many orientations and positions, andthese terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, theperson of ordinary skill in the art will readily appreciate that thevarious methods and devices disclosed herein can be used in numeroussurgical procedures and applications including, for example, inconnection with open surgical procedures. As the present DetailedDescription proceeds, those of ordinary skill in the art will furtherappreciate that the various instruments disclosed herein can be insertedinto a body in any way, such as through a natural orifice, through anincision or puncture hole formed in tissue, etc. The working portions orend effector portions of the instruments can be inserted directly into apatient's body or can be inserted through an access device that has aworking channel through which the end effector and elongated shaft of asurgical instrument can be advanced.

Turning to the Drawings wherein like numerals denote like componentsthroughout the several views, FIG. 1 depicts a surgical instrument 10010that is capable of practicing several unique benefits of the presentinvention. The surgical instrument 10010 is designed to manipulateand/or actuate various forms and sizes of end effectors 10012 that areoperably attached to an elongated shaft assembly 10100 of the surgicalinstrument. In the depicted embodiment, for example, the end effector10012 comprises a surgical stapling device that has openable andclosable jaws 10013 and 10015. More specifically, the end effector 10012includes an elongated channel 10014 that forms a lower jaw 10013 of theend effector 10012. See FIG. 2 . In the illustrated arrangement, theelongated channel 10014 is configured to operably support a staplecartridge 10030 and also movably supports an anvil assembly 10020 thatfunctions as an upper jaw 10015 of the end effector 10012.

In various implementations, the end effector 10012 is configured to becoupled to an elongated shaft assembly 10100 that protrudes from ahandle assembly or housing 10400. See FIG. 1 . The end effector 10012(when closed) and the elongated shaft assembly 10100 may have similarcross-sectional shapes and be sized to operably pass through a trocartube or working channel in another form of access instrument. As usedherein, the term “operably pass” means that the end effector and atleast a portion of the elongated shaft assembly 10100 may be insertedthrough or passed through the channel or tube opening and can bemanipulated therein as needed to complete the surgical staplingprocedure. In some embodiments, for example, when in a closed position,the jaws 10013 and 10015 of the end effector 10012 may provide the endeffector with a roughly circular cross-sectional shape that facilitatesits passage through a circular passage/opening. However, the endeffectors of various embodiments of the present invention, as well asthe elongated shaft assembly embodiments, could conceivably be providedwith other cross-sectional shapes that could otherwise pass throughaccess passages and openings that have non-circular cross-sectionalshapes. Thus, an overall size of a cross-section of a closed endeffector will be related to the size of the passage or opening throughwhich it is intended to pass. Thus, one end effector for example, may bereferred to as a “5 mm” end effector which means it can operably passthrough an opening that is at least approximately 5 mm in diameter.

In various implementations, the elongated shaft assembly 10100 may havean outer diameter that is substantially the same as the outer diameterof the end effector 10012 when the end effector 10012 is in a closedposition. For example, a 5 mm end effector may be coupled to anelongated shaft assembly 10100 that has 5 mm cross-sectional diameter.However, as the present Detailed Description proceeds, it will becomeapparent that various embodiments of the present may be effectively usedin connection with different sizes of end effectors. For example, a 10mm end effector may be attached to an elongated shaft that has a 5 mmcross-sectional diameter. Conversely, for those applications wherein a10 mm or larger access opening or passage is provided, the elongatedshaft assembly 10100 may have a 10 mm (or larger) cross-sectionaldiameter, but may also be able to actuate a 5 mm or 10 mm end effector.Accordingly, the outer shaft assembly 10100 may have an outer diameterthat is the same as or is different from the outer diameter of a closedend effector 10012 attached thereto.

Referring now to FIGS. 2 and 3 , the elongated channel 10014 maycomprise an elongated trough 10700 that is configured to removablysupport a surgical staple cartridge 10030 thereon. In variousimplementations, for example, the elongated channel 10014 may befabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainlesssteel, titanium, etc. and be formed with spaced side walls 10702. Aswill be discussed in further detail below, the anvil assembly 10020 mayinclude a distal anvil portion 10800 and a proximal anvil mounting tube10820. The distal anvil portion 10800 may, for the most part, besubstantially coextensive with the portion of the elongated channel10014 that supports the staple cartridge 10030. The distal anvil portion10800 may be fabricated from, for example, 300 & 400 Series, 17-4 & 17-7stainless steel, titanium, etc. and have a staple forming undersurface,generally labeled as 10022 that has a plurality of staple formingpockets (not shown) formed therein.

The elongated channel 10014 may be configured to support a variety ofdifferent surgical staple cartridges that are designed to be “implanted”within the patient. For example, the implantable surgical staplecartridge 10030 may comprise any of the various surgical staplecartridge arrangements disclosed in U.S. Patent Application PublicationNo. 2012/0080484, filed on Sep. 30, 2010, and entitled SURGICAL STAPLINGINSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM, now U.S. Pat. No.9,113,862, the entire disclosure of which is hereby incorporated byreference herein. In at least one implementation for example, the staplecartridge 10030 includes a body portion 10031 that consists of acompressible hemostat material such as, for example, oxidizedregenerated cellulose (“ORC”) or a bio-absorbable foam in which lines ofunformed metal staples 10032 are supported. In at least someembodiments, in order to prevent the staple from being affected and thehemostat material from being activated during the introduction andpositioning process, the entire cartridge may be coated or wrapped in abiodegradable film such as a polydioxanon film sold under the trademarkPDS® or with a Polyglycerol sebacate (PGS) film or other biodegradablefilms formed from PGA (Polyglycolic acid, marketed under the trade markVicryl), PCL (Polycaprolactone), PLA or PLLA (Polylactic acid), PHA(polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under thetrademark Monocryl) or a composite of PGA, PCL, PLA, PDS that would beimpermeable until ruptured. The body 10031 of staple cartridge 10030 issized to be removably supported within the elongated channel 10014 asshown such that each staple 10032 therein is aligned with correspondingstaple forming pockets in the distal anvil portion 10800 when the distalanvil portion 10800 is driven into forming contact with the staplecartridge 10030.

Referring to FIG. 3 , the elongated channel 10014 may further include aboxed mounting end 10710 that includes a pair of spaced side walls 10712and a top wall 10714. In at least one implementation, the end effector10012 is configured to be articulated relative to the elongated shaftassembly 10100 about an articulation and pivot axis A-A about which theanvil assembly 10020 is pivoted relative to the elongated channel 10014.The elongated shaft assembly 10100 defines a longitudinal tool axisLT-LT. The articulation and pivot axis A-A is transverse to thelongitudinal tool axis LT-LT. The elongated shaft assembly 10100comprises a hollow outer shaft 10300 and serves to function as the shaftspine of the elongated shaft assembly 10100. The proximal end of theelongated shaft assembly 10100 may be rotatably supported by the handleassembly 10400 so that the clinician may selectively rotate theelongated shaft assembly 10100 and the end effector 10012 attachedthereto about the longitudinal tool axis LT-LT. The distal end 10302 ofthe outer shaft 10300 is formed with a clevis arrangement 10304 thatcomprises a pair of spaced attachment tabs 10306. Each attachment tab10306 has a mounting hole 10308 therein that is adapted to receive acorresponding pivot pin 10310 therethrough.

In various implementations, the anvil assembly 10020 includes a distalanvil portion 10800 and a proximal anvil mounting tube 10820. As can beseen in FIGS. 2, 3 and 5 , the proximal anvil mounting tube 10820includes a body portion 10821 that has a proximally extending clevisportion 10822 that is formed by two proximally extending anvilattachment tabs 10824. Each anvil attachment tab 10824 has an anvilmounting hole 10826 therethrough that is configured to be pivotallyjournaled on the pivot pins 10310. In various implementations, thedistal anvil portion 10800 is configured to be coupled to the proximalanvil mounting tube 10820 such that the distal anvil portion 10800 may“float” relative to the proximal anvil mounting tube 10820. Referring toFIG. 5 , the body 10821 of the proximal anvil mounting tube 10820 may beformed with a series of opposed, vertically-extending opened endedgrooves 10830. Grooves 10830 are sized to slidably receive thereincorresponding vertically extending attachment lugs 10812 formed on aproximal end 10810 of the distal anvil portion 10800. See FIG. 4 . Eachattachment lug 10812 has a stop lug 10814 formed thereon that is sizedto be movably received in a stop groove 10832 formed in each groove10830 as shown in FIG. 5 . Each stop groove 10832 has a closed end10834. The proximal end 10810 of the distal anvil portion 10800 ismovably coupled to the proximal anvil mounting tube 10820 by aligningthe attachment lugs 10812 with the open bottom ends of the correspondinggrooves 10830 and then inserting the proximal end upward into theproximal anvil mounting tube 10820. This assembly may be completedbefore the anvil assembly 10020 is pivotally journaled on the pivot pins10310. Once assembled and pivotally coupled to the elongated channel10014, the distal anvil portion 10800 will be unable to slidablydisengage the proximal anvil mounting tube 10820 due to contact withelongated channel 10014. The stop lugs 10812 will likewise contact theclosed ends 10834 of the corresponding stop groove 10832 to prevent theproximal end 10810 of the distal anvil portion 10800 from becomingdisconnected from the proximal anvil mounting tube 10820. See FIG. 7 .As can be seen in FIG. 7 , the distal anvil portion 10820 may moveupward (arrow “U”) and downward (arrow “D”) relative to the proximalanvil mounting tube 10820. Such range of vertical travel of the distalanvil portion 10800 relative to the proximal anvil mounting portion10820 may be referred to herein as “floating” vertical travel ormovement.

Referring now to FIG. 8 , initial closure of the anvil assembly 10020relative to the elongated channel assembly 10014 and the surgical staplecartridge 10030 operably supported therein may be accomplished by aunique and novel closure system, generally designated as 10110. Theclosure system 10110 may also be referred to herein as the “second jawclosure system”. In one implementation, the closure system 10110includes an anvil closure rod 10112 that has a proximal end 10114 thathas a flanged end 10116 that is configured to be rotatably attached to aclosure carriage 10420 of the closure system that is operably supportedwithin the housing assembly 10400. See FIG. 8 . The anvil closure rod10112 may also be referred to herein as the “second jaw actuator bar10112.” The closure carriage and firing system may be similar inconstruction and operation to the closure carriage and closure systemdisclosed in U.S. Patent Application Publication No. 2012/0074200,entitled SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE ENDEFFECTOR, which was filed on Sep. 23, 2011, the entire disclosure ofwhich is hereby incorporated by reference herein.

Referring again to FIG. 8 , the closure carriage 10420 may comprise twocarriage segments 10422 (only one is illustrated) that areinterconnected together by adhesive, snap features, screws, etc. As usedherein, the term “snap feature” includes, but is not limited to, forexample, a tab that has a protrusion thereon that is configured toretainingly engage a corresponding mating portion of another component.Such features may be designed to releasably engage the mating portion orit may not be designed or intended to be removed. In at least one form,the closure carriage 10420 has a distal end 10424 that has a groovearrangement 10426 that is adapted to receive the flanged end 10116 ofthe anvil closure rod 10112. Such arrangement serves to attach theproximal end 10114 of the anvil closure rod 10112 to the closurecarriage 10420 while facilitating its selective rotation of the anvilclosure rod 10112 relative to the closure carriage 10420. Therefore, theelongated shaft assembly 10100 and the end effector 10012 that isoperably coupled thereto may be selectively rotated about thelongitudinal tool axis LT-LT relative to the housing assembly 10400.

Still referring to FIG. 8 , in various implementations, the housingassembly 10400 comprises a pistol-shaped handle housing that may befabricated in two or more pieces for assembly purposes. For example, thehousing assembly 10400 as shown comprises a right hand case member 10402and a left hand case member 10404 (FIG. 1 ) that are molded or otherwisefabricated from a polymer or plastic material and are designed to matetogether. Such case members 10402 and 10404 may be attached together bysnap features, pegs and sockets molded or otherwise formed thereinand/or by adhesive, screws, etc. When assembled, the housing assembly10400 movably supports the closure carriage 10420 for selective axialtravel therein in response to actuation motions from a trigger,generally designated as 10430. As the present Detailed Descriptionproceeds, however, it will be understood that the various unique andnovel aspects and attributes of the various implementations of thepresent invention may be effectively attained when employed withrobotically controlled or otherwise remotely controlled systems. Thus,the term “housing” or “housing assembly” may also encompass a housing orsimilar portion of a robotic or automated control system that houses orotherwise operably supports at least one drive system that is configuredto generate and apply at least one control motion which could be used toactuate various forms of surgical end effectors attached thereto. Forexample, various implementations of the surgical instruments describedherein may be used in connection with those robotic systems andarrangements disclosed in U.S. patent application Ser. No. 13/536,323,entitled ROBOTICALLY POWERED SURGICAL DEVICE WITH MANUALLY ACTUATABLEREVERSING SYSTEM, and filed Jun. 28, 2012, now U.S. Pat. No. 9,408,606,the entire disclosure of which is hereby incorporated by referenceherein.

The trigger assembly 10430 may, for example, comprise a primary trigger10440 and a secondary trigger 10460. The primary and secondary triggers10440 and 10460 are pivotally journaled on a pivot pin assembly 10430formed in the housing assembly 10400 such that the triggers 10440 and10460 may essentially move relative to each other. Such arrangementpermits the trigger assembly 10430 to pivot relative to the housingassembly 10400 about a pivot axis PA-PA. See FIG. 8 . The primarytrigger 10440 has an elongated, grippable primary trigger paddle 10442that protrudes from a primary drive portion 10444 that has a firing rack10446 formed thereon. In one embodiment, the secondary trigger 10460 hasa secondary trigger paddle 10462 that protrudes from a secondary driveportion 10464 that is pivotally journaled on the pivot pin assembly10430. The primary drive portion 10444 has a slot 10448 that is adaptedto receive the secondary drive portion 10464 of the secondary trigger10460 therein as the primary trigger paddle 10442 is pivoted towards apistol grip portion 10406 of the housing assembly 10400. Sucharrangement essentially enables the secondary trigger 10460 to “nest”within the primary trigger 10440 during actuation. As will be discussedin detail below, the secondary trigger 10460 is pivotally actuated bypivoting the primary trigger 10440. Thus, in other embodiments, thesecondary trigger 10460 may lack the secondary trigger paddle 10442. Invarious forms, the trigger assembly 10430 may be biased into theunactuated position by a trigger spring (not shown).

As can be seen in FIG. 8 , the secondary drive portion 10464 of thesecondary trigger 10460 may have a closure gear segment 10466 formedthereon that is configured for meshing engagement with a carriage gearrack 10423 formed on the underside of the closure carriage 10420. Thus,when the secondary trigger 10460 is pivoted toward the pistol grip10406, the closure carriage 10420 is driven in the distal direction “DD”which thereby drives the anvil closure rod 10112 in the distaldirection.

Referring again to FIG. 3 , a distal end 10118 of the anvil closure rod10112 is configured to be pinned to an anvil closure link 10120. Theanvil closure link 10120 is pivotally pinned to an anvil pin slide10122. An anvil cam pin 10124 is mounted to the anvil pin slide 10122 anis configured to be received within anvil pin slots 10720 provided ineach of the lateral side walls 10712 of the boxed mounting end 10710 ofthe elongated channel 10014 as well as anvil cam slots 10840 in theproximal anvil mounting tube 10820. Movement of the anvil closure rod10112 in the distal direction “DD” will cause the anvil assembly 10020to move from an open position towards the elongated channel 10014(referred to herein as the “closing direction “CD”) and movement of theanvil closure rod 10112 in the proximal direction “PD” will cause theanvil assembly 10020 to move from a closed position to an open position(referred to herein as the opening direction “OD”). Such opening andclosing of the anvil assembly 10020 is accomplished by the cammingaction or movement of the anvil pin 10124 in the anvil camming slots10840 in the proximal anvil mounting tube 10820. Thus, actuation of theclosure system 10110, also known as the “second jaw closure system” willresult in movement of the anvil assembly 10020, also known as the“second jaw 10015” relative to the elongated channel 10014, also knownas the “first jaw 10013”. Such movement may, for example, comprisepivotal travel of the second jaw (anvil assembly 10020) relative to thefirst jaw (elongated channel 10014) about a common pivot axis A-A thatis established at their points of attachment to the distal end of theelongated shaft assembly 10100.

In various arrangements, the end effector 10012 may be configured to beselectively articulated relative to the longitudinal tool axis LT-LT.Stated another way, however, the first jaw 10013 which comprises theelongated channel 10014 may be selectively movable relative to thesecond jaw 10015 which comprises the anvil assembly 10020. As describedabove, the elongated channel 10014 is pivotally coupled to the distalend 10302 of the outer tube 10300 by pivot pins 10310. Such attachmentarrangement permits the elongated channel 10014 to articulate or move ina first direction “FD” about the pivot axis A-A which is essentially thesame direction that the anvil assembly 10020 moves in when the anvilassembly 10020 is moved from a closed position to an open position (theanvil opening direction “OD”). See FIG. 9 . Such arrangement furtherfacilitates movement or articulation in a second articulation direction“SD” that is essentially the same as the direction that the anvilassembly 10020 moves from an open position to a closed position (theanvil closing direction “CD”). To facilitate such movement of theelongated channel 10014, a reciprocatable articulation rod 10150 isemployed. The articulation rod 10150 may also be referred to herein asthe “first jaw actuator bar 10150”. More specifically and with referenceto FIG. 3 , the articulation rod 10150 is sized to be movably receivedwith the outer tube 10300 and has a distal end 10152 that is pivotallypinned to an articulation link 10160. The articulation link 10160 ispivotally pinned to a proximal attachment lug 10722 on the proximalboxed mounting end 10710 of the elongated channel 10014. As can be seenin FIG. 10 , a proximal end 10154 of the articulation rod 10150 has anarticulation rack 10156 formed thereon that drivingly interfaces with anarticulation control system 10200. The articulation control system 10200may also be referred to herein as the “first jaw closure system 10200”.

The component parts of one form of articulation control system 10200 areillustrated in FIGS. 10 and 11 . In one form, the articulation controlsystem 10200 may include an actuator 10210, an articulation body 10220and a nozzle 10250. Rotational movement of the actuator 10210 causescorresponding rotation of the articulation body 10220 within the nozzle10250. Rotation of the actuator 10210 thereby results in the axialtravel of the articulation rod 10150 within the outer shaft 10300 tocause the remote articulation of the end effector 10012.

Still referring to FIG. 10 , the articulation body 10220 has a deck10222 consisting of first and second spaced-apart, semicircular deckhalves, 10224, 10226. The deck halves are mutually opposed to each otherand essentially represent mirror images of each other. The first andsecond deck halves 10224, 10226 have protruding from their surfacesmutually opposed first and second detents 10225, 10227, respectively.Each deck half 10224, 10226 has a set of deck teeth 10228 spaced about180 degrees from the set of deck teeth on the other deck half. Thearticulation body 10220 has a pair of rotation stops 10230 protrudingfrom its surface as well as a pair of finger recesses 10232. A drivegear 10240 protrudes laterally from the articulation body 10220. Thedrive gear 10240 has a flared opening 10242 through it, and a lateralpivot 10244. Within the flared opening 10242 of the drive gear 10240,there is a firing rod orifice (not shown) for receiving a firing rod10530 therethrough enabling the application of a firing motion to theend effector 10012. The drive gear 10240 is configured to intermesh withthe articulation rack 10156 to effect the desired reciprocating movementof the articulation rod 10150.

The nozzle 10250 of the articulation control system 10200 may include anozzle body 10252. The nozzle body 10252 may have an axial bore 10254therethrough that facilitates the passage of the articulation rod 10150and other operative components of the instrument 10010 including aproximal end 10305 of the outer shaft 10300. See FIG. 11 . The nozzlebody 10252 may also have a frame groove 10256 and flange 10258 torotatably fasten the nozzle body 10252 to the housing 10400. In variousforms, a detent housing 10260 comprises a portion of the nozzle body10252. See FIG. 1 . An annular array of detent teeth (not shown) isformed within the detent housing 10260. A detent housing floor is spacedfrom the detent teeth. The floor may have a pair of ledges whichinteract within the rotation stops 10230 of the articulation body 10220to limit the degree of rotation. When the articulation body 10220 isinserted into the detent housing 10260, the base of the articulationbody 10220 is supported on the floor within the detent housing 10260,and the deck teeth 10228 of the first and second deck halves, 10224,10226 are aligned for meshing engagement with the detent teeth of thedetent housing 10260. A spring member 10268 is supported within thearticulation body to bias the deck teeth 10228 into meshing engagementwith the detent teeth.

Referring again to FIG. 10 , the actuator 10210 may consist of a leverarm 10212, a cap 10214 and a pair of retaining fingers 10216. The leverarm 10212 is mounted on the top of the cap 10214. The pair of retainingfingers 10216 protrudes laterally from the underside of the cap 10214.Each of the retaining fingers 10216 has a retaining clip. The retainingfingers 10216 are received within the finger recesses 10232 of thearticulation body 10220. First and second detents, 10225, 10227, on thedeck halves of the articulation body are inserted into a slot depressionwithin the underside of the circular cap 10214. Advantageously, each ofthe three significant components of the articulation control system,namely the actuator, articulation body and nozzle, may be injectionmolded components. Such components, for example, may be fabricated froma glass fiber-reinforced amorphous polyamide, sold commercially underthe trade name Grivory GV-4H by EMS—American Grilon 150.

Ratcheting rotation of the actuator 10210 causes articulation of theelongated channel 10014 in the first or second directions relative tothe longitudinal tool axis LT-LT. FIGS. 1, 2, 9 and 12 illustrate theelongated channel 10014 in an unarticulated position. When the drivegear 10240 on the articulation body 10220 of the articulationtransmission 10200 is rotated to thereby push the articulation rod 10150in the distal direction “DD”, the elongated channel 10014 willarticulate in the first articulation direction “FD” relative to thelongitudinal tool axis LT-LT as shown in FIG. 13 . When the drive gear10240 on the articulation body 10220 of the articulation transmission10200 has been rotated to thereby pull the articulation rod 10112 in theproximal direction “PD”, the elongated channel 10014 will pivot in asecond direction “SD” relative to the longitudinal tool axis LT-LT. Thesecond direction “SD” is the same as the closure direction “CD”. SeeFIG. 9 .

The surgical instrument 10010 may include a firing system generallydesignated as 10410 that is supported within the housing assembly 10400and is operable to actuate various components of the instrument 10010.Referring to FIG. 8 , the firing system 10410 may, for example, includean actuation bar 10470. The actuation bar 10470 has a first actuationrack 10472 formed thereon that is configured for meshing engagement withthe firing rack 10446 on the primary trigger 10440. Thus, when thefiring rack 10446 is in meshing engagement with the first actuation rack10472, the actuation bar 10470 is driven in the distal direction “DD”when the primary trigger 10440 is pivoted toward the pistol grip 10406.The actuation bar 10470 has a second actuation rack 10474 formed thereonconfigured to meshingly engage clutch teeth 10484 on a clutch shaft10482 of a clutch assembly 10480. In various embodiments, the clutchshaft 10482 is rotatably is supported within the housing assembly 10400and is also laterally movable therein. The clutch shaft 10482 has a hubportion 10486 that has a plurality of spaced teeth 10488 that areconfigured to drivingly engage teeth openings 10492 in a drive gear10490 that is rotatably supported on the clutch shaft 10482. The drivegear 10490 has a segment of drive gears 10494 thereon that are adaptedfor meshing engagement with a firing rack 10500 that is movablysupported in the housing assembly 10400.

Various embodiments of the clutch assembly 10480 may further comprise aclutch plate 10510 that is slidably journaled on a clutch pin 10449provided on the primary drive portion 10444 of the primary trigger10440. The clutch pin 10449 may be movably received within a verticalslot 10512 in the clutch plate 10510. The clutch plate 10510 also has adistally-extending clutch arm 10514 that is adapted to actuatably engagea bevel plate 10489 formed on the clutch shaft 10482. In addition, aclutch spring 10520 is employed to bias the clutch shaft 10480 laterallysuch that the teeth 10488 on the clutch shaft 10482 are brought intomeshing engagement with the teeth openings 10492 in the drive gear10490.

As can be seen in FIG. 8 , the firing rack 10500 is coupled to a firingrod 10530 that is attached to the proximal end of a knife bar assembly10600. In various embodiments, the knife bar assembly 10600 may comprisea three-ply flexible knife bar 10602 that is flexible enough toaccommodate articulation of the end effector 10012, while remainingsufficiently rigid to be driven distally through the elongated shaftassembly 10100. An axial passage 10157 may be provided in thearticulation bar 10150 for axially receiving the knife bar 10602therein. See FIG. 10 . In the depicted embodiment, the knife bar 10602is attached to an I beam cutting head 10610. As can be seen in FIG. 3 ,for example, the I-beam cutting head 10610 includes a verticallyoriented body portion 10612 that has a bottom foot 10614 and an uppertab 10616 formed thereon. A tissue cutting edge 10620 is formed on thevertically oriented body portion 10612.

Still referring to FIG. 3 , the vertically oriented body portion 10612extends through a longitudinally extending slot 10704 in the elongatedchannel 10014 and a longitudinally extending slot 806 in the distalanvil portion 10800. The distal anvil portion 10800 further has a trough10809 formed in the upper surface for slidably receiving the upper tab10616 therein. The distal end 10618 of the upper tab 10616 is sloped tointerface with sloped surfaces 10811 formed on the portions 10805 of thedistal anvil portion 10800 forming the slot 806. See FIG. 14 . Theflexible firing bar 10602 extends through the elongated shaft assembly10100 to be coupled to a distal end portion 10532 of a firing rod 10530are supported in a contiguous orientation relative to each other asshown in FIG. 10 . The proximal end of the firing bar 10602 may beattached to the distal end portion 10532 of the firing rod 10530 by acoupler member 10650. As will be discussed in further detail below, thefiring rod 10530 facilitates the application of firing and retractionmotions to the knife bar assembly 10600 by the firing system 10410.

Referring again to FIG. 8 , the firing rod 10530 extends through aclosure bushing 10540 that is mounted within the housing assembly 10400.In at least one form, a pair of mounting studs 10407 protrude from thehandle case members 10402, 10404 and extend through corresponding slotsin the closure carriage 10420 to be received in a retaining slot in thebushing 10540. A closure spring 10550 that is attached to a retainerclip 10552 is journaled on the closure bushing 10540. The closure spring10550 extends between the nozzle body 10252 and an internal wall 10425in the closure carriage 10420. Thus, the closure spring 10550 serves tobias the closure carriage 10420 in the proximal direction “PD”.

Various embodiments may also include a releasable closure lockingassembly 10560 that interfaces with the closure carriage 10420 toselectively retain the closure carriage 10420 in its distal-most closedor clamped position. In at least one form, the closure locking assembly10560 includes a locking button 10562 that is pivotally supported in thehousing assembly 10400. The locking button 10562 has a latch arm 10564that is configured to abut a locking ledge 10421 formed on the closurecarriage 10420 when the button 10562 is in the locked position. Inaddition, the latch arm 10564 has a catch 10566 formed thereon that isconfigured to releasably latch with a locking latch 10502 on theproximal end of the firing rack 10500. A locking spring 10568 serves tobias the locking button 10562 into the locked position.

Operation of the surgical instrument 10010 will now be described. FIG. 9illustrates the jaws 10013 and 10015 of the end effector 10012 in anopen position. When the end effector 10012 is in the open position, thelatch arm 10564 is located on top of the locking ledge 10421 formed onthe closure carriage 10420 such that the catch 10566 of the latch arm10564 is in retaining engagement with the locking latch 10502 on thefiring rack 10500. See FIG. 8 . Thus, when in this initial startingposition, the knife bar assembly 10600 cannot be inadvertently actuated.The clutch plates 10510, as well as the closure carriage, are each intheir proximal-most unactuated positions. When in those positions, theclutch drive bevel 10489 on the clutch shaft 10482 is in contact with aportion of the closure carriage 10420, which prevents the clutch shaft10482 from laterally moving into meshing engagement with the drive gear10490 under the bias of the clutch spring 10520.

To initiate the closure process, a first stroke is applied to thetrigger assembly 10430. That is, the trigger assembly 10430 is initiallypivoted toward the pistol grip 10406. Such pivoting action serves todrive the closure carriage 10420 in the distal direction “DD” by virtueof the meshing engagement between the closure gear segment 10466 on thesecondary trigger 10460 and the carriage rack 10423 formed on theunderside of the closure carriage 10420. Such distal movement of theclosure carriage 10420 also axially advances the anvil closure rod 10112in the distal direction “DD”. As the anvil closure rod 10112 movesdistally, the closure link 10120 moves the anvil pin slide 10122distally. As the anvil pin slide 10122 moves distally, anvil pin 10124moves up cam slots 10840 in the proximal anvil portion 10820 to cam theanvil assembly 10020 towards the elongated channel 10014 and the staplecartridge 10030 supported therein. If the surgeon desires to simplygrasp and manipulate tissue prior to clamping it between the anvilassembly 10020 and the surgical staple cartridge 10030, the triggerassembly 10430 may be pivoted to open and close the anvil assembly 10020without fully pivoting the trigger assembly 10430 to the fully closedposition.

Those of ordinary skill in the art will understand that, as the triggerassembly 10430 is pivoted toward the pistol grip 10406, the actuationbar 10470 will necessarily also be driven distally by virtue of themeshing engagement between the primary gear segment 10446 on the primarytrigger 10440 and the first actuation rack 10472 on the actuation bar10470. The distal movement of the actuation bar 10470 will also resultin the an application of a rotary actuation motion to the clutch shaft10482 by virtue of the meshing engagement between the clutch teeth 10484on the clutch shaft 10482 and the second actuation rack 10474 on theactuation bar 10470. However, such rotary motion is not applied to thedrive gear 10490 because the clutch arm 10514 of the clutch plate 10510,in contact with the clutch drive bevel 10489 on the clutch shaft 10482,prevents the axial movement of the clutch shaft 10482 into meshingengagement with the drive gear 10490. Thus, the clutch shaft 10482freely rotates relative to the drive gear 10490. Accordingly, the clutchassembly 10480 automatically prevents the activation of the firing rack10500 during the initial actuation of the trigger assembly 10430.

Once the trigger assembly 10430 has been initially fully compressed intothe closed position, the anvil assembly 10020 will be locked in theclosed position by the closure locking assembly 10560 which prevents theproximal movement of the closure carriage 10420. To drive the knife barassembly 10600 distally through the tissue clamped in the end effector10012, the surgeon again pivots the primary trigger 10440 toward thepistol grip 10406 of the housing assembly 10400. As the primary trigger10440 is pivoted, the firing rack 10500, the firing rod 10530, and theknife bar assembly 10600 are driven in the distal direction “DD”. As theknife bar assembly 10600 is driven in the distal direction, the cuttinghead 10610 also moves distally. As the cutting head 10610 movesdistally, the sloped distal end 10618 on the upper tab 10616 travels upthe sloped surfaces 10811 on the distal anvil portion 10800 moving thefloating distal anvil portion 10800 in the down direction “D” towardsthe staple cartridge 10030. As the distal anvil portion 10800 is drivendownwardly towards the clamped tissue and the staple cartridge 10030,the clamping or crushing action causes the staples to be formed againstthe underside of the distal anvil portion 10800. Thus, as the cuttinghead 10610 is driven distally through the end effector 10012, the tissuecutting surface 10620 thereon severs the clamped tissue while formingthe staples in the staple cartridge 10030 on both sides of the cuttissue. Such two part anvil assembly enables the distal anvil portion toessentially remain parallel to the elongated channel and top of thesurgical staple cartridge during firing. Stated even more succinctly,the two part floating anvil arrangement enables the staple-formingundersurfaces to remain parallel with the top of the surgical staplecartridge and the elongated channel during firing.

After the cutting head 10610 has been driven through the tissue clampedin the end effector 10012, the surgeon then releases the primary trigger10440 to thereby permit the primary trigger 10440 to pivot to itsunactuated position under the bias of the firing spring 10432. As theprimary trigger 10440 pivots back to the starting position, the firingrack 10500, firing rod 10530, and knife bar assembly 10600 are drawnproximally back to their respective starting positions. The end effector10012 remains in its clamped position as shown in FIG. 13 .

To unlock the closure carriage 10420 and the secondary trigger 10460,the surgeon depresses the locking button 10562. As the locking button10562 is depressed, the locking arm 10564 is pivoted out of abuttingengagement with the locking ledge 10426 on the closure carriage 10420.Further details regarding the operation of the firing and closuresystems may be found in U.S. Patent Application Publication No.2012/0074200 which has been herein incorporated by reference in itsentirety. As the closure carriage 10420 moves proximally, the anvilclosure rod 10112 is also drawn proximally. As the anvil closure rod10112 moves proximally, the anvil pin slide 10122 and anvil pin 10124move proximally camming the anvil assembly 10020 to the open position.

The surgical instrument 10010 provides a host of advantages over priorsurgical instruments. For example, the unique and novel floating anvilarrangement is able to automatically adjust the anvil gap between theundersurface of the anvil and the staple cartridge or elongated channel.Thus, the floating anvil arrangement can automatically compensate fordifferent thickness of tissue while enabling the staple formingundersurface(s) of the anvil to remain parallel to the staple cartridgeand elongated channel. This is all accomplished without sacrificinganvil stability.

Another distinct advantage that the surgical instrument 10010 enjoysover prior surgical instruments with an articulatable end effector isthe nature in which the present end effector is articulatable relativeto the elongated shaft assembly. As described in detail above, theelongated channel portion of the end effector is pivotally mounted tothe elongated shaft assembly for selective pivotal travel relativethereto about a pivot axis. The pivot axis is transverse to thelongitudinal tool axis defined by the elongated shaft assembly. Theanvil assembly is also pivotally coupled to the elongated channel forselective pivotal travel relative thereto about the same pivot axis.This provides another distinct advantage over prior articulatable endeffector arrangements for at least the following reason.

During typical surgical procedures, the surgeon is viewing the surgicalsite and the end effector through a camera that can provide somewhatlimited viewing. For example, such camera arrangements commonly onlyafford the surgeon with a view of a portion of the surgical endeffector. When using an endocutter for example, the camera may onlyafford the surgeon a view of a portion of the endocutter's anvil and/orchannel. In prior articulatable endocutter arrangements, the endocutterwas coupled to the end of the elongated shaft by a flexible joint orother arrangement that did not always afford a consistent reference axisabout which the end effector would pivot relative to the elongatedshaft. So it was difficult for the surgeon when viewing a portion of theend effector to have a reliable frame of reference to know where thepivot axis resided. By having the articulation axis also be the axisabout which the anvil pivots, the surgeon has a much more reliable frameof reference regarding the location of the pivot axis when viewing theendocutter's anvil through the camera. Stated another way, when usingthe end effector arrangement of the surgical instrument 10010 thesurgeon can determine where the elongated channel is going to pivotrelative to the elongated shaft by viewing where the anvil is pivotallymounted to the elongated channel.

The surgical instrument 10010 also employs separate control systems formoving the end effector jaws 10013 and 10015 relative to each other. Forexample, the clinician may elect to move or articulate the lower jaw10013 (elongated channel 10014) about the pivot axis A-A toward or wayfrom the upper jaw 10015 (anvil assembly 10020) without actuating theupper jaw 10015 (anvil assembly 10020). This may be accomplished byactuating the articulation control system (or first jaw closure system)without actuating the second jaw closure system 10110. Thus, theelongated channel 10014 may be selectively pivoted about the pivot axisA-A while the anvil assembly 10020 remains in an open or closedposition. Similarly, the anvil assembly 10020 may be actuated or movedwithout moving the elongated channel 10014 by actuating the closuresystem 10110 without actuating the articulation control system. Suchunique and novel arrangement provides the clinician with moreflexibility when positioning the end effector jaws within the patient.

FIGS. 15-19 illustrate another surgical instrument 1010 that is capableof practicing several unique benefits of the present invention. Thesurgical instrument 1010 is designed to manipulate and/or actuatevarious forms and sizes of end effectors 1012 that are operably attachedto an elongated shaft assembly 1100 of the surgical instrument. In thedepicted embodiment, for example, the end effector 1012 comprises asurgical stapling device that has openable and closable jaws 1013 and1015. More specifically, the end effector 1012 includes a jaw channel1014 that forms a lower jaw 1013 of the end effector 1012. See FIG. 16 .In the illustrated arrangement, the jaw channel 1014 is configured tooperably support a staple cartridge 10030 and also movably supports ananvil assembly 1020 that functions as an upper jaw 1015 of the endeffector 1012.

Referring now to FIGS. 15 and 17 , the anvil assembly 1020 comprises atwo-part arrangement including an anvil body portion 1021 and an anvilcap member 1023. The anvil body portion 1021 may include a mountingportion 1022 that has mounting trunnions 1024 protruding therefrom. Themounting trunnions 1024 are configured to be received in verticallyelongated mounting slots 1018 in the upstanding side walls 1017 of aproximal mounting portion 1016 of the jaw channel 1014. Such arrangementpermits the anvil assembly to somewhat float up and down relative to theelongated channel. Stated another way, the anvil body portion 1021 maymove relative to the elongated channel or the top of a staple cartridgesupported in the elongated channel such that the staple formingundersurfaces of the anvil body portion 1021 are parallel to the top ofthe staple cartridge and the elongated channel. As will be discussed infurther detail below, the anvil assembly 1020 is moved between open andclosed positions by manipulating the position of a tissue cutting head1190.

In various arrangements, the end effector 1012 may be configured to beselectively articulated about a longitudinal tool axis LT-LT that isdefined by the elongated shaft assembly 1100. As can be seen in FIGS.15-18 , for example, the elongated shaft assembly 1100 may include aflexible neck assembly 1110 to facilitate such articulation. Variousflexible neck assemblies are known and may be employed. For example,flexible neck assemblies are disclosed in U.S. Provisional PatentApplication Ser. No. 61/386,117, entitled ARTICULATING SURGICAL DEVICE,and filed Sep. 24, 2010, the entire disclosure of which is hereinincorporated by reference. Other flexible neck assemblies which may beemployed are disclosed in U.S. Pat. No. 5,704,534, entitled ARTICULATIONASSEMBLY FOR SURGICAL INSTRUMENTS, and issued on Jan. 6, 1998; U.S.Patent Application Publication No. 2012/0074200, entitled SURGICALINSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR, and filed onSep. 23, 2011; and U.S. Patent Application Publication No. 2009/0090764,entitled SURGICAL STAPLER HAVING AN ARTICULATION MECHANISM, and filedOct. 3, 2008, now U.S. Pat. No. 7,909,220, the entire disclosures ofeach being hereby incorporated by reference herein in their respectiveentireties. As will be discussed in further detail below, however, theflexible neck assembly 1110 is configured to facilitate articulation ofthe end effector 1012 in directions that are the same directions inwhich the jaws of the end effector travel between open and closedpositions.

In at least one implementation, the flex neck assembly 1110 may, forexample, be fabricated in two pieces 1110R and 1110L that are configuredto be coupled together by, fasteners such as snap features, screws,bolts, adhesive, etc. The flexible neck pieces 1110R and 1110L may becomposed of rigid thermoplastic polyurethane sold commercially asISOPLAST grade 2510 by the Dow Chemical Company. The right flexible neckportion 1110R includes a right upper rib segment 1112R and a right lowerrib segment 1112L that are separated by an elongated right lateral spine(not shown). Similarly, the left flexible neck portion 1110L includes aleft upper rib segment 1112L and a left lower rib segment 1114L that areseparated by a left elongated lateral spine 1116. See FIG. 17 . Whenassembled together, the right upper rib segments 1112R and the leftupper rib segments 1112L form upper ribs 1112 and the right lower ribsegments 1114R and the left lower rib segments 1114L form lower ribs1114 that are spaced from each other and which together form acylindrical configuration as shown in FIG. 15 . Such arrangement enablesthe end effector 1012 to articulate in a first direction “FD” that isessentially the same direction that the anvil assembly 1020 moves inwhen the anvil assembly 1020 is moved from a closed position to an openposition (hereinafter referred to as the anvil opening direction “OD”).See FIG. 18 . The flexible neck assembly 1110 will further facilitatearticulation of the end effector 1012 in a second articulation direction“SD” that is essentially the same as the direction that the anvil movesfrom an open position to a closed position (hereinafter referred to theanvil closing direction “CD”). In various embodiments, the rightflexible neck portion 1110R further has a right tubular portion 1113Rand the left flexible neck portion 1110L has a left tubular portion1113L. When joined together, the right and left tubular portions 1113R,1113L serve to receive therein two distally protruding attachment arms1019 that protrude proximally from the jaw channel 1014. See FIGS. 16and 17 . The attachment arms 1019 have attachment tabs thereon thatengage the tubular portions 1113R, 1113L to affix the jaw channel 1014to the elongated shaft assembly 1100. Other methods of attaching the jawchannel 1014 to the elongated shaft assembly 1100 may also be employed.In at least one embodiment, the elongated shaft assembly 1100 includes asubstantially rigid proximal outer shaft segment 1300 that has a distalend 1302. The distal end 1302 has a pair of opposed lateral slots 1303therein for receiving the corresponding proximally protruding ends ofthe lateral spine portions 1116L (the right spine portion is not shown).See FIGS. 15 and 17 . The outer shaft segment 1300 may be pressed ontothe flexible neck assembly 1110 or otherwise attached thereto byfasteners, pins, screws, etc.

The proximal end of the outer shaft segment 1300 may be attached to ahandle assembly of the type disclosed in U.S. Patent ApplicationPublication No. 2012/0074200, entitled SURGICAL INSTRUMENT WITHSELECTIVELY ARTICULATABLE END EFFECTOR, which has been hereinincorporated by reference in its entirety. Further details regarding atleast one method of attaching the outer shaft segment to the handleassembly and operation of the outer shaft segment and related componentsmay be gleaned from reference to that publication. Such arrangementpermits the surgeon to rotate the outer shaft segment 1300 and the endeffector 1012 operably coupled thereto about the longitudinal tool axisLT-LT by rotating the nozzle member relative to the handle assembly asdiscussed in detail therein.

Referring to FIGS. 16 and 18 , an upper slot 1120 extends through eachof the upper ribs 1112 to form a passage through the flexible neckassembly 1110 for receiving a first flexible articulation band assembly1150 therethrough. Similarly, a lower slot 1121 extends through each ofthe lower ribs 1114 in the flexible neck assembly 1110 to form a passagefor receiving a second flexible articulation band assembly 1170therethrough. Referring to FIG. 17 , in at least one embodiment, thefirst flexible articulation band assembly 1150 comprises a flexiblefirst distal segment 1152 that is fabricated from, for example, springsteel, 420 stainless steel, titanium, 400 or 300 grade stainless steeland has a first hook 1154 formed in its distal end. The first hook 1154is configured to hookingly engage a first or upper hook-receivingfeature 1155U formed in the proximal end of the jaw channel 1014. Thefirst articulation band assembly 1150 further includes a firststructural band portion 1156 that is attached to (e.g., pinned) to thefirst distal segment 1152. The first structural band portion 1156 may befabricated from, for example, spring steel, 420 stainless steel,titanium. Likewise, the second articulation band assembly 1170 comprisesa flexible second distal segment 1172 that is fabricated from, forexample, spring steel, 420 stainless steel, and titanium and has asecond or lower hook 1174 formed in its distal end. See FIG. 17 . Thesecond hook 1174 is configured to hookingly engage a second or lowerhook-receiving feature 1155L formed in the jaw channel 1014. See FIG. 18. The second articulation band assembly 1170 further includes a secondstructural band portion 1176 that is attached to (e.g., pinned) to thesecond distal segment 1172. The second structural band portion 1176 maybe fabricated from, for example, 400 or 300 grade stainless steel. Theupper and lower articulation band assemblies 1150, 1170 may interfacewith and be controlled by an articulation transmission and controlsystem 2000 of the type described in U.S. Patent Application PublicationNo. 2012/0074200 which has been incorporated by reference herein in itsentirety.

Referring to FIG. 19 , various embodiments of the articulation system2000 include a novel articulation transmission 2030 that is supportedwithin the handle assembly 1900 for applying articulation motions to thefirst and second articulation band assemblies 1150, 1170. In variousforms, the articulation transmission 2030 includes an actuator wheel2040 that is rotatably supported on the handle assembly 1900 forselective rotation about an actuation axis. In at least one embodiment,the actuation axis coincides with or is substantially coaxial with thelongitudinal tool axis LT-LT. Thus the actuation axis does nottransversely intersect the longitudinal axis. In other embodiments, theactuation axis may be substantially parallel to the longitudinal axis.To facilitate ease of assembly and manufacturing, the actuator wheel2040 is fabricated in two pieces 2040A that may be attached together byscrews, snap features, adhesive etc. When assembled, the actuator wheel2040 has a first set of actuator threads 2042 which are configured in afirst direction for threaded engagement with a first thread nut assembly2060. In addition, the actuator wheel 2040 also has a second set ofactuator threads 2044 which are configured in a second direction thatdiffers from the first direction. For example, the first threads 2042may comprise “right hand” threads and the second threads 2044 maycomprise “left hand” threads or vice versa. The second threads 2044 areadapted to threadably engage a second threaded nut assembly 2070.

In various embodiments, the first threaded nut assembly 2060 comprises afirst disc 2062 that has first threads 2064 formed thereon. The firstdisc 2062 is supported on a knife tube 1800 by a first bearing bushing2066. The first bearing bushing 2066 facilitates movement of the firstdisc 2062 relative to the knife tube 1800. Similarly, the secondthreaded nut assembly 2070 comprises a second disc 2072 that has secondthreads 2074 formed thereon. The second disc 2072 is supported on theknife tube 1800 by a second bearing bushing 2076 that facilitatesmovement of the second disc 2072 relative to the knife tube 1800. Thefirst and second discs 2062, 2072 are also movably supported on upperand lower nut rails 2050, 2052 that are mounted to standoff posts 1905molded into the handle cases 1904. See FIG. 19 . The upper and lower nutrails 2050, 2052 serve to prevent the first and second discs 2062, 2072from rotating relative to the handle housing and therefore, as theactuator wheel 2040 is rotated relative to the handle housing, the firstand second bearing bushings 2066, 2076 move axially on the knife tube1800 in different directions.

The first and second articulation band assemblies 1150, 1170 arecontrolled by rotating the actuator wheel 2040 relative to the handleassembly 1900. To facilitate the application of such control motions,the first structural band portion 1156 has a first catch memberconfigured to retainingly engage the first bearing bushing 2066 and thesecond structural band portion 1176 has a second catch member configuredto retainingly engage the second bearing bushing 2076. In addition, thearticulation system 2000 in at least one form includes an elongatedsupport beam 2080 that extends longitudinally within the knife tube 1800to provide lateral support to the first and second structural bandportions 1156, 1176 within the knife tube 1800. The support beam 2080may be fabricated from, for example, 400 or 300 grade stainless steeland is configured to facilitate axial movement of the first and secondstructural band portions 1156, 1176 while providing lateral supportthereto.

FIGS. 15 and 16 illustrate the surgical instrument 1010 in anunarticulated position. That is, when in an unarticulated position, theend effector 1012 is substantially axially aligned on the longitudinaltool axis LT-LT. When in that “neutral” position, the first and seconddiscs 2062, 2072 are spaced away from each other. To provide the surgeonwith an indication when the articulation system 2000 has been parked inthe neutral position, a detent assembly 2090 is mounted within thehandle housing. The detent assembly 2090 into the housing and is adaptedto engage a recess (not shown) in the hub portion 2041 of the actuatorwheel 2040. See FIG. 19 . The detent assembly 2090 is configured toengage the recess when the actuator wheel 2040 is in the neutralposition. When the detent 2090 engages the recess, the surgeon mayreceive a tactile and/or audible indication.

The articulation system 2000 may articulate the end effector 1012 aboutthe flexible neck assembly 1110 in the following manner. First, thesurgeon rotates the articulation actuator wheel 2040 in a first rotarydirection which causes the first and second discs 2062, 2072 to movetoward each other. As the first disc 2062 moves in the proximaldirection “PD”, the first articulation band assembly 1150 is pulled inthe proximal direction “PD” by virtue of the first catch feature 2017which is coupled to the first bearing bushing 2066. Likewise, as thesecond disc 2072 moves in the distal direction “DD”, the secondarticulation band assembly 1170 is pushed in the distal direction “DD”by virtue of the second catch feature 2027 which is coupled to thesecond bearing bushing 2076. Such action of the first and secondarticulation band assemblies 1150, 1170 causes the end effector 10612 toarticulate in the first articulation direction “FD” by virtue of thefirst and second articulation bands 1150, 1170 interconnection with theend effector 1012. To articulate the end effector in the secondarticulation direction “SD”, the user simply rotates the articulationactuator wheel 2040 in a second rotary direction that is opposite to thefirst rotary direction.

As indicated above, the articulation system 2000 in at least one formalso includes an elongated support beam 2080 that extends longitudinallywithin the knife tube 1800 to provide lateral support to the first andsecond structural band portions 1150 and 1170 within the knife tube1800. The support beam 2080 may be fabricated from, for example, 400 or300 grade stainless steel and is configured to facilitate axial movementof the first and second structural band portions 1156, 1176 whileproviding lateral support thereto. In addition, the right and leftsegments 1110R, 1110L of the flexible neck assembly 1110, when joinedtogether, form a passage 1118 for receiving a knife bar assembly 1180.In various forms, the knife bar assembly 1180 includes a distal knifebar portion 1182 that includes an upper knife bar 1184 and a lower knifebar 1186 that are attached to a tissue cutting head 1190. The upperknife bar 1184 is attached to a top portion 1192 of the tissue cuttinghead 1190 and the lower knife bar 1186 is attached to a lower portion1194 of the tissue cutting head 1190. The upper knife bar 1184 and thelower knife bar 1186 are configured to flex as the flexible neckassembly 1110 flexes.

As will be discussed in further detail below, in at least oneembodiment, the axial advancement and withdrawal of the knife barassembly 1180 may be controlled by, for example, the manual activationof a firing trigger that is operably supported on the handle assembly1900. As can be seen in FIG. 19 , a connector member 1790 is coupled toa proximal end 1183 of the distal knife bar portion 1182. In at leastone embodiment, for example, the connector member 1790 is pinned to theproximal end 1787 of the distal knife bar portion 1182 and has aproximally protruding attachment feature 1792 that is configured to becoupled to a distal end 1802 of the hollow knife tube 1800. The hollowknife tube 1800 extends through the outer shaft segment 1300 and intothe handle assembly 1900 and is attached to a carriage assembly 1810. Invarious embodiments, for example, the carriage assembly 1810 comprises aflanged carriage bushing 1812 that is press fit onto a portion of theknife tube 1800. The carriage assembly 1810 further comprises a firingcarriage 1814 that has a saddle formed therein configured to extend overthe carriage bushing 1812 between the bushing flanges 1813. In at leastone form, the firing carriage 1814 also has a pair of laterallyextending portions 1816 that each have a support tab 1818 formedthereon. The support tabs 1818 are configured to be slidably received ina corresponding slide passage (not shown) formed in the handle housing1904. Such arrangement permits the firing carriage 1814 to move axiallywithin the handle assembly 1900 and thereby apply axial actuationmotions to the knife tube 1800 while permitting the knife tube 1800 torotate about the longitudinal tool axis LT-LT relative to the firingcarriage 1814 as the nozzle assembly 1770 is rotated.

In at least one embodiment, actuation motions may be manually applied tothe firing carriage 1814 by a firing trigger assembly 1820 that ispivotally supported on the handle assembly 1900. The firing triggerassembly 1820 includes a firing trigger 1822 that has an attachmentplate 1824 that is configured to operably interface with a pair ofactuation plates 1826. As can be seen in FIG. 19 , the attachment plate1824 is located between the actuation plates 1826 and is pivotallypinned thereto by a first pivot pin 1828 that extends through slots 1830in the actuation plates 1826 and a hole 1825 in the attachment plate1824. A second pivot pin 1832 is received within or is supported bymounting lugs in the handle cases 1904 and extends between holes 1834 inthe actuation plates 1826. Each of the actuation plates 1826 have a lug1836 that extends into a corresponding pocket or opening 1815 in thefiring carriage 10814. Such arrangement facilitates the application ofaxial actuation motions to the knife tube 1800 by pivoting the firingtrigger 1822 relative to the handle housing 1900. As the firing trigger10822 is pivoted towards the pistol grip portion 1908 of the handlehousing 1900, the firing carriage 1814 is driven in the distal direction“DD”. As the firing trigger 1822 is pivoted away from the pistol gripportion 1908 of the handle housing 1900, the firing carriage 1814 drawsthe knife tube 1800 in the proximal direction “PD”.

Various embodiments of the surgical instrument 1010 may further includea locking system 1840 that includes a locking trigger 1842 that ispivotally coupled to the handle housing 1900. The locking trigger 1842includes a locking bar portion that is configured to operably engage alocking member 1846 that is pivotally attached to the attachment plate1824 of the firing trigger 1822 by pin 1849. Further discussionregarding the operation of the locking system 1840 may be found in U.S.Patent Application Publication No. 2012/0074200.

Actuation of the end effector 1012 will now be explained. While graspingthe pistol grip portion 1908 of the handle assembly 1900, the surgeonmay apply a closing motion to the anvil assembly 1020 of the endeffector 1012 by applying an actuation force to the firing trigger 1822.Such action results in the application of an actuation motion to thefiring carriage 1814 by the actuation plates 1826 which ultimatelyresults in the axial displacement of the knife tube 1800 in the distaldirection “DD”. As the knife tube 1800 is advanced in the distaldirection “DD”, the knife bar assembly 1180 is likewise driven in thedistal direction “DD”. As the knife bar assembly 1180 and, moreparticularly the tissue cutting head 1190, is driven in the distaldirection “DD”, the upper tab portions 1196 on the tissue cutting head1190 contact sloped surfaces 1025 on the anvil body 1021 to start toapply a closing motion to the anvil assembly 1020. Further applicationof the actuation force to the firing trigger 1822 results in furtheraxial displacement of the knife tube 1800 and the tissue cutting head1090. Such action further moves the anvil assembly 1020 towards theelongated jaw channel 1014. As the firing trigger 1822 is pivotedtowards the pistol grip portion 1908 of the handle assembly 1900, thelocking member 1848 also pivots in the counterclockwise “CCW” directionabout the pin 1849. At this point, the tissue cutting head 1190 isprevented from moving any further in the distal direction “DD” by virtueof the locking system 1840. Thus, the surgeon may move the anvilassembly 1020 to capture and manipulate tissue in the end effector 1012without risk of actually “firing” the end effector 1012 (i.e., orcutting the tissue and forming the staples).

Once the surgeon desires to cut tissue and form staples, a secondactuation force is applied to the locking trigger 1842. When the lockingtrigger 842 is depressed, the locking bar portion 1844 pivots to aforward position which thereby permits the locking member 1848 tocontinue to pivot in the counterclockwise direction as the surgeoncontinues to apply the actuation force to the trigger 1822. Suchactuation of the firing trigger 1822 results in the axial displacementof the tissue cutting head 1190 through the anvil assembly 1020 and theelongated jaw channel 1014. At this point, the upper tab portions 1196and the lower foot 1198 on the tissue cutting head 1190 serves to spacethe anvil assembly 1020 relative to the elongated jaw channel 1014 suchthat the staples 10032 in the staple cartridge 10030 are formed into thetissue on each side of the tissue cut line.

After completing the cutting and stapling process, the firing trigger1822 may be released. A return spring (not shown) attached to the firingtrigger 1822 returns the firing trigger 1822 to the unactuated position.Alternative, the user can use the hook feature of the trigger to “pull”open the trigger if no spring is used. As the firing trigger 1822 movesin the clockwise “CW” direction, the firing carriage 1814 is moved inthe proximal direction “PD” which also moves the knife bar assembly 1180in the proximal direction “PD”. As the tissue cutting head 1190 returnsto its starting position, the upper tabs 1196 on the tissue cutting head1190 contact an arcuate opening surface 1027 on the underside of theanvil cap 1023 as shown in FIG. 18 . Continued movement of the tissuecutting head 1190 in the proximal direction “PD” causes the anvilassembly 1020 to pivot open by virtue of its contact with the arcuatesurface 1027.

The surgical instrument 1010 also provides advantages over priorsurgical instruments. For example, the unique and novel floating anvilarrangement is able to automatically adjust the anvil gap between theundersurface of the anvil and the staple cartridge or elongated channel.Thus, the floating anvil arrangement can automatically compensate fordifferent thickness of tissue while enabling the staple formingundersurface(s) of the anvil to remain parallel to the staple cartridgeand elongated channel. This is all accomplished without sacrificinganvil stability.

FIGS. 20-26 depict another surgical instrument 3010 that is capable ofpracticing several unique benefits of the present invention. Thesurgical instrument 3010 is designed to manipulate and/or actuatevarious forms and sizes of end effectors 3012 that are operably attachedto an elongated shaft assembly 3100 of the surgical instrument. In thedepicted embodiment, for example, the end effector 3012 comprises asurgical stapling device that has openable and closable jaws 3013 and3015. More specifically, the end effector 3012 includes an elongatedchannel 3014 that forms a lower jaw 3013 of the end effector 3012. SeeFIGS. 21 and 10022 . In the illustrated arrangement, the elongatedchannel 3014 is configured to operably support a staple cartridge 10030of the type and construction described herein. For example, the surgicalstaple cartridge includes a cartridge body 10031 that operably supportsa plurality of unformed surgical staples 10032 therein. The elongatedchannel 3014 also movably supports an anvil assembly 3020 that functionsas an upper jaw 3015 of the end effector 3012.

In various implementations, the end effector 3012 is configured to becoupled to an elongated shaft assembly 3100 that protrudes from a handleassembly or housing 3400. See FIG. 20 . The handle assembly 3400 may besimilar to one of the handle assemblies disclosed herein and/or in U.S.Patent Application Publication No. 2012/0074200 except for thedifferences discussed herein.

Referring to FIG. 23 , the elongated channel 3014 may comprise anelongated trough 3016 that is configured to removably support a surgicalstaple cartridge 10030 thereon. In various implementations, for example,the elongated channel 3014 may be fabricated from, for example, 300 &400 Series, 17-4 & 17-7 stainless steel, titanium, etc. and be formedwith spaced side walls 3018. The body 10031 of staple cartridge 10030 issized to be removably supported within the elongated channel 3014 asshown such that each staple 10032 therein is aligned with correspondingstaple forming pockets in the anvil assembly 3020 when the anvilassembly 3020 is driven into forming contact with the staple cartridge10030. The elongated channel 3014 may further include a proximal end3200 that includes a pair of spaced side walls 3202. In at least oneimplementation, the end effector 3012 is configured to be articulatedrelative to the elongated shaft assembly 3100 about an articulation andpivot axis A-A about which the anvil assembly 3020 is pivoted relativeto the elongated channel 3014. The elongated shaft assembly 3100 definesa longitudinal tool axis LT-LT. The articulation and pivot axis A-A istransverse to the longitudinal tool axis LT-LT. The elongated shaftassembly 3100 comprises a hollow outer shaft 3300 and serves to functionas the shaft spine of the elongated shaft assembly 3100. The proximalend of the outer shaft 3300 may be rotatably supported by the handleassembly 3400 so that the clinician may selectively rotate the elongatedshaft assembly 3100 and the end effector 3012 attached thereto about thelongitudinal tool axis LT-LT. For example, the proximal end of theelongated shaft assembly may be operably coupled to a nozzle assembly3250 that is rotatably supported on the handle assembly 3400. Rotationof nozzle assembly 3250 relative to the handle assembly 3400(represented by arrow “R”) will result in rotation of the elongatedshaft assembly 3100 as well as the end effector 3012 coupled thereto.See FIG. 20 .

Referring again to FIG. 23 , the distal end 3302 of the outer shaft 3300is formed with a clevis arrangement 3304 that comprises a pair of spacedattachment tabs 3306. Each attachment tab 3306 has a mounting hole 3308therein that is adapted to receive a corresponding pivot pin 3204 thatis formed on each upstanding side wall 3202. Thus, the elongated channel3014 is selectively pivotable or articulatable about the pivot axis A-Arelative to the elongated shaft assembly 3100. The anvil assembly 3020includes a distal anvil portion 3022 and a proximal anvil mountingportion 3030. The distal anvil portion 3022 may, for the most part, besubstantially coextensive with the portion of the elongated channel 3014that supports the staple cartridge 10030 and be fabricated from, forexample, 300 & 400 Series, 17-4 & 17-7 stainless steel, titanium, etc.The distal anvil portion 3022 comprises two spaced apart anvil arms 3024that protrude distally from the anvil mounting portion 3030 to define anelongated slot 3026 therebetween. Each of the spaced-apart anvil arms3024 has a staple forming undersurface, generally labeled as 3028 thathas a plurality of staple forming pockets (not shown) formed therein.

The anvil mounting portion 3030 has a pair of mounting holes 3032 (onlyone is shown in FIG. 23 ) that are adapted to pivotally receive thereinthe corresponding pivot pins 3204 that protrude from the side walls 3202of the proximal end 3200 of the elongated channel 3014. Such arrangementserves to pivotally mount the anvil assembly 3020 to the elongatedchannel 3014 for selective pivotal travel about pivot axis A-A betweenan open position (FIGS. 24 and 25 ) and a closed position (FIGS. 21, 22and 26 ).

Articulation of the end effector 3012 about the pivot axis A-A as wellas actuation of the anvil assembly 3020 between open and closedpositions may be controlled by a single firing system generallydesignated as 3500. In at least one implementation, for example, thefiring system 3500 includes an actuation pivot 3510 that is movablysupported between the upstanding side walls 3202 of the elongatedchannel 3014. The actuation pivot 3510 includes a distal cam surface3512 and a proximal cam surface 3514. The distal cam surface 3512 isconfigured to operably interface with an inwardly protruding distalanvil pin 3034 that protrudes from the anvil mounting portion 3030. Theproximal cam surface 3514 is configured to operably interface with aninwardly protruding proximal anvil pin 3036 that also protrudes inwardlyfrom the anvil mounting portion 3030. As can be seen in FIG. 23 , thedistal anvil pin 3034 extends inwardly through the correspondingelongated distal slots 3206 in the upstanding side walls 3202 of theproximal end 3200 of the elongated channel 3014. Likewise, the proximalanvil pin 3036 extends inwardly through corresponding elongated slots3208 in the upstanding side walls 3202 of the proximal end 3200 of theelongated channel 3014.

The firing system 3500 may be controlled, for example, by a closuretrigger arrangement on a handle assembly 3400 of the type disclosed inU.S. Patent Application Publication No. 2012/0074200. For example, thefiring system 3500 may include an actuation bar 3520 that is movablycoupled to the actuation pivot 3510. The actuation bar 3520 may have,for example, an attachment ball member 3522 formed on the distal endthereof that is rotatably received within a semi-circular groove 3516 inthe actuation pivot 3510. Such arrangement permits the actuation pivot3510 to pivot or otherwise move relative to the actuation bar 3520.Other methods of movably coupling the actuation bar 3520 to theactuation pivot 3510 may also be employed. The actuation bar 3520 mayextend through the hollow outer shaft 3300 and be operably coupled to,for example, the closure carriage arrangement disclosed in theaforementioned published patent application such that actuation of thetrigger 10440 will result in the axial travel of the actuation bar 3520within the outer shaft 3330. In various implementations, a series ofsupport collars 3530, 3532, 3534 may be provided in the outer shaft 3300to provide support to the actuation bar 3520 within the outer shaft3300.

In use, the end effector 3012 is articulated into a desired positionprior to closing the anvil assembly 3020. Of course, if the end effector3012 must be inserted through a trocar or other opening in the patient,the clinician can move the anvil assembly 3020 to the closed position(FIG. 21 ) without articulating the end effector 3012 so that the endeffector 3012 is coaxially aligned with the elongated shaft assembly3100. The clinician manipulates the trigger 10440 to position theactuation pivot 3510 so that the cam surfaces 3512 and 3514 interactwith the pins 3034, 3036 to result in the closure of the anvil assembly3020 without articulating the end effector 3012. Once the end effector3012 has been inserted through the trocar or other opening, theclinician may actuate the trigger 10440 to move the actuation pivot 3510to the position shown in FIG. 24 . When in that position, the actuationpivot 3510 causes the anvil assembly 3020 to move to the open positionwithout being articulated. The clinician may then articulate the endeffector 3012 about the pivot axis A-A relative to the elongated shaftassembly 3100 by further actuating the trigger 10440 to move theactuation pivot 3510 to the position shown, for example, in FIG. 25 . Ascan be seen in that Figure, the end effector 3012 has pivoted in a firstdirection “FD” which is the same general direction that the anvilassembly 3020 moves when it moves from a closed position to the openposition (referred to herein as the “opening direction ‘OD’”). Ifdesired, the user may actuate the trigger 10440 to thereby cause the endeffector 3012 to move in a second direction “SD” that is the samegeneral direction that the anvil assembly 3020 moves when it is movedfrom the open position to a closed position (referred to herein as the“closing direction “CD”). Once the user has positioned the end effector3012 in the desired position, the user further actuates trigger 10440 tomanipulate the actuation pivot to the position illustrated in FIG. 26 tothereby clamp the target tissue “T” between the anvil assembly 3020 andthe staple cartridge 10030.

The surgical instrument 3010 further includes a knife bar assembly 3600that can be attached to the firing bar and firing rack arrangementdisclosed herein and/or in U.S. Patent Application Publication No.2012/0074200 such that it can be controlled by actuating the secondarytrigger 10460. In various embodiments, the knife bar assembly 3600 maycomprise an upper bar segment 3602 and a lower bar segment 3604. Sucharrangement may enable the knife bar assembly 3600 to flex as the endeffector 3012 is articulated, while remaining sufficiently rigid to bedriven distally through the shaft assembly 3100. In the depictedembodiment, the upper and lower knife bar segments 3602, 3604 are eachattached to a cutting head 3610. In the depicted configuration, thecutting head 3610 includes a vertically oriented body portion 3612 thathas an upper portion 3615 and a lower portion 3617. A bottom foot 3614is formed on or attached to the lower portion 3617. Similarly, an uppertab 3616 is formed on or otherwise attached to the upper portion 3615 ofthe vertically oriented body portion 3612. In addition, as can be seenin FIG. 23 , the vertically oriented body portion 10612 further includesa tissue cutting edge 3620.

Referring to FIG. 23 , the vertically oriented body portion 3612 extendsthrough a longitudinally extending slot 3210 in the elongated channel3014 and the longitudinally extending slot 3026 in the anvil assembly3020. When assembled, the upper portion 3615 of the cutting head 3610extends through a proximal upper opening 3031 in the anvil mountingportion 3030 of the anvil assembly 3020. Thus, when the cutting head3610 is distally advanced, the upper tab portions 3616 ride on the anvilarms 3024. Likewise the bottom foot 3614 protrudes through a loweropening 3212 in the elongated channel 3014 such that it rides below theelongated channel as the cutting head 3610 is advanced distally. As thecutting head 3610 is advanced distally, the cutting edge 3620 thereonsevers the tissue clamped in the end effector 3012. The surgical staplecartridge 10030 is crushed between the anvil assembly 3020 and theelongated channel 3014 thereby causing the staples 10032 supportedtherein to be formed on both sides of the tissue cut line as they arebrought into contact with the staple forming underside of the anvilassembly 3020. After the cutting head 3610 has been advanced to thedistal end of the end effector, 3012, the user retracts the cutting head3610 to the starting position in the manner discussed herein and thetrigger 10440 is actuated to open the anvil assembly 3020 to release thestaple cartridge and stapled tissue.

As was discussed in detail above, by having the articulation axis alsobe the axis about which the anvil pivots, the surgeon has a much morereliable frame of reference regarding the location of the pivot axiswhen viewing the endocutter's anvil through the camera. Stated anotherway, when using the end effector arrangement of the surgical instrument10010 the surgeon can determine where the elongated channel is going topivot relative to the elongated shaft by viewing where the anvil ispivotally mounted to the elongated channel.

FIGS. 27-35 illustrate another surgical instrument arrangement 4010 thatmay employ various components of other surgical instruments disclosedherein except for the differences discussed below. The surgicalinstrument 4010 is designed to manipulate and/or actuate various formsand sizes of end effectors 4012 that are operably attached to anelongated shaft assembly 4100 of the surgical instrument. In thedepicted embodiment, for example, the end effector 4012 comprises asurgical stapling device that has openable and closable jaws 4013 and4015. More specifically, the end effector 4012 includes an elongatedchannel 4014 that forms a lower jaw 4013 of the end effector 4012. SeeFIG. 28 . In the illustrated arrangement, the elongated channel 4014 isconfigured to operably support a staple cartridge 10030 and also movablysupports an anvil assembly 4020 that functions as an upper jaw 4015 ofthe end effector 4012.

In various implementations, the end effector 4012 is configured to becoupled to an elongated shaft assembly 4100 that protrudes from a handleassembly or housing 4400. See FIG. 27 . The handle assembly 4400 may besimilar to one of the handle assemblies disclosed herein and/or in U.S.Patent Application Publication No. 2012/0074200 except for anydifferences discussed below. Alternative embodiments, however, may beemployed with and actuated by robotic systems as was discussedhereinabove.

Referring to FIGS. 28 and 29 , the elongated channel 4014 may comprisean elongated trough 4016 that is configured to removably support asurgical staple cartridge 10030 thereon. In various implementations, forexample, the elongated channel 3014 may be fabricated from, for example,300 & 400 Series, 17-4 & 17-7 stainless steel, titanium, etc. and beformed with spaced side walls 4018. The body 10031 of staple cartridge10030 is sized to be removably supported within the elongated channel3014 as shown such that each staple 10032 therein is aligned withcorresponding staple forming pockets in the anvil assembly 4020 when theanvil assembly 4020 is driven into forming contact with the staplecartridge 10030. The elongated channel 4014 may further include asomewhat box-like proximal end 4200 that includes a pair of spaced sidewalls 4202 that have a top flap 4203 protruding inwardly therefrom todefine a slot 4205 therebetween. The sidewalls 4202 are coupled togetherby a support bar 4207 that extends therebetween. See FIGS. 29, 31 and 32.

In at least one implementation, the elongated channel 4014 is configuredto be moved or articulated relative to the elongated shaft assembly 4100and the anvil assembly 4020 about a pivot axis A-A about which the anvilassembly 4020 is also pivotally mounted. The elongated shaft assembly4100 defines a longitudinal tool axis LT-LT. The pivot axis A-A istransverse to the longitudinal tool axis LT-LT. The elongated shaftassembly 4100 comprises a hollow outer shaft 4300 and serves to functionas the shaft spine of the elongated shaft assembly 4100. The proximalend of the outer shaft 4300 may be rotatably supported by the handleassembly 4400 so that the clinician may selectively rotate the elongatedshaft assembly 4100 and the end effector 4012 attached thereto about thelongitudinal tool axis LT-LT.

Referring again to FIG. 29 , the distal end 4302 of the outer shaft 4300is formed with a clevis arrangement 4304 that comprises a pair of spacedattachment tabs 4306. Each attachment tab 4306 has a mounting hole 4308therein that is adapted to receive a corresponding pivot pin 4310 thatdefines the pivot axis A-A. The pivot pins 4310 also extend throughcorresponding openings 4210 in the upstanding side walls 4202 of theproximal mounting end 4200 of the elongated channel 4014. Thus, theelongated channel 4014 is selectively pivotable or articulatable aboutthe pivot axis A-A relative to the elongated shaft assembly 4100 and theanvil assembly 4020. The anvil assembly 4020 includes a distal anvilportion 4022 and an proximal anvil mounting portion 4030. The distalanvil portion 4022 may, for the most part, be substantially coextensivewith the portion of the elongated channel 3014 that supports the staplecartridge 10030 and be fabricated from, for example, 300 & 400 Series,17-4 & 17-7 stainless steel, titanium, etc. The distal anvil portion4022 comprises two spaced apart anvil arms 4024 that protrude distallyfrom the anvil mounting portion 4030 to define an elongated slot 4026therebetween. Each of the spaced-apart anvil arms 4024 has astaple-forming undersurface, generally labeled as 4028 that has aplurality of staple forming pockets (not shown) formed therein. Theanvil mounting portion 4030 has a pair of mounting holes 4032 that areadapted to pivotally receive therein the corresponding pivot pins 4310.Such arrangement serves to pivotally mount the anvil assembly 4020 tothe outer shaft 4300 for selective pivotal travel about pivot axis A-Abetween an open position (FIGS. 32 and 33 ) and a closed position (FIGS.28, 30 and 31 ) relative to the elongated channel assembly 4014.

Initial closure of the anvil assembly 4020 relative to the elongatedchannel assembly 4014 and the surgical staple cartridge 10030 operablysupported therein may be accomplished by a unique and novel closuresystem, generally designated as 4110. The closure system 4110 may alsobe referred to herein as the “second jaw closure system”. In oneimplementation, the closure system 4110 includes an anvil closure rod4112 that has a proximal end that may be operably coupled to the closurecarriage in the handle assembly 4400 in the various manners discussedherein and also disclosed in further detail in U.S. Patent ApplicationPublication No. 2012/0074200. For example, the proximal end of theclosure rod 4112 may have a flange (not shown) that is configured to berotatably attached to a closure carriage that is operably supportedwithin the housing assembly 4400. Thus, actuation of the trigger 10440will result in the axial advancement of the anvil closure rod 4112within the outer shaft 4300.

Such arrangement also enables the elongated shaft assembly 4100 and theend effector 4012 that is operably coupled thereto may be selectivelyrotated about the longitudinal tool axis LT-LT relative to the housingassembly 4400. The anvil closure rod 4112 may also be referred to hereinas the “second jaw actuator bar.”

Referring again to FIG. 29 , a distal end 4118 of the anvil closure rod4112 is configured to be pinned to an anvil closure link 4120. The anvilclosure link 4120 is pivotally pinned to an anvil pin slide 4122 by apin 4123. The anvil pin slide 4122 includes two spaced side walls 4124that define a space 4125 therebetween that is configured to receive aportion of a tissue cutting head 4610 as will be discussed in furtherdetail below. An anvil cam pin 4034 is mounted to the anvil mountingportion 4030 and extends through elongated slots 4208 in the upstandingside walls 4202 of the proximal end 4200 of the elongated channel 4014as well as through cam slots 4126 provided through the side walls 4124of the anvil pin slide 4122. FIG. 32 illustrates the positions of theanvil slide 4122 and the anvil cam pin 4034 when the anvil assembly 4020is in the open position. To move the anvil assembly 4020 to a closedposition relative to the elongated channel assembly 4014 (FIG. 31 ), theclinician can actuate the trigger 10440 which drives the anvil closurerod 4112 in the distal direction “DD”. Such movement of the anvilclosure rod 4112 in the distal direction also moves the anvil pin slide4122 in the distal direction “DD”. As the anvil pin slide 4122 moves inthe distal direction, the camming action of the anvil pin 4034 in theslots 4126 and 4208 cams the anvil assembly 4020 in the closingdirection “CD” to the closed position as shown in FIG. 31 . Movement ofthe anvil closure rod 4112 in the proximal direction “PD” will cause theanvil assembly 4020 to move in the opening direction “OD”.

In various arrangements, the end effector 4012 may be configured to beselectively articulated relative to the longitudinal tool axis LT-LT.Stated another way, the elongated channel assembly 4014 may beselectively articulatable or movable relative to the anvil assembly4020. As described above, the elongated channel 4014 is pivotallycoupled to the distal end 4302 of the outer tube 4300 by pivot pins4310. Such attachment arrangement permits the end elongated channelassembly 4014 to articulate in a first direction “FD” about thearticulation and pivot axis A-A which is essentially the same directionthat the anvil assembly 4020 moves in when the anvil assembly 4020 ismoved from a closed position to an open position (the anvil openingdirection “OD”). Such arrangement further facilitates articulation ormovement in a second articulation direction “SD” that is essentially thesame as the direction that the anvil assembly 4020 moves from an openposition to a closed position (the anvil closing direction “CD”). Tofacilitate such movement of the elongated channel assembly 4014 relativeto the anvil assembly 4020, a reciprocatable articulation rod 4150 isemployed. The articulation rod 4150 may also be referred to herein asthe “first jaw actuator bar”. More specifically and with reference toFIG. 29 , the articulation rod 4150 is sized to be movably received withthe outer tube 4300 and has a distal end 4152 that is pivotally pinnedto a pair of articulation links 4160. The articulation links 4160 arepivotally pinned to the proximal portion of the elongated channel 4014by an articulation pin 4161. As can be seen in FIG. 34 , a proximal end4154 of the articulation rod 4150 has an articulation rack 4156 formedthereon that drivingly interfaces with an articulation control system10200 of the type described hereinabove. As indicated above, thearticulation control system 10200 may also be referred to herein as the“first jaw closure system”. Ratcheting rotation of the actuator 10210 ofthe articulation transmission 10200 causes articulation of the elongatedchannel assembly 4014 in the first or second directions relative to theanvil assembly 4020. FIGS. 28, 30, 31 and 31 illustrate the elongatedchannel assembly 4014 in an unarticulated position. When the drive gear10240 on the articulation body 10220 of the articulation transmission10200 is rotated to thereby push the articulation rod 4150 in the distaldirection “DD”, the elongated channel assembly 4014 will move in thefirst articulation direction “FD” relative to the anvil assembly 4020 asshown in FIG. 33 . When the drive gear 10240 on the articulation body10220 of the articulation transmission 10200 has been rotated to therebypull the articulation rod 10112 in the proximal direction “PD”, theelongated channel assembly 4014 will pivot in a second direction “SD”relative to the anvil assembly 4020. The second direction “SD” is thesame as the closure direction “CD”. See FIG. 33 .

The surgical instrument 4010 as illustrated in FIG. 27 may furtherinclude an firing system of the type described herein and/or in U.S.Patent Application Publication No. 2012/0074200 that may be controlledby actuating trigger 10460. Referring to FIG. 34 , a firing rack 10500is coupled to a firing rod 10530 that is attached to the proximal end ofa knife bar assembly 4600. In various forms, the knife bar assembly 4600includes a distal knife bar portion 4602 that includes an upper knifebar 4604 and a lower knife bar 4606 that are attached to an I-beamcutting head 4610. The upper knife bar 4604 and the lower knife bar 4606are configured to flex as the end effector 4012 is articulated. As canbe seen in FIG. 29 , for example, the I-beam cutting head 4610 includesa vertically oriented body portion 4612 that has a bottom foot 4614 andan upper tab 4616 formed thereon. A tissue cutting edge 4620 is formedon the vertically oriented body portion 4612.

Still referring to FIG. 29 , the vertically oriented body portion 4612extends through a longitudinally extending slot 4704 in the elongatedchannel 4014 and the longitudinally extending slot 4026 in the distalanvil portion 4024. The distal anvil portion 4024 further has a trough4025 formed in the upper surface for slidably receiving the upper tab4616 therein. The distal end of the upper tab 6616 may be sloped tointerface with sloped surfaces 4027 formed on the anvil arms 4024 of thedistal anvil portion 4022. The flexible firing bars 4604, 4606 extendthrough the elongated shaft assembly 4100 to be coupled to a distal endportion 10532 of a firing rod 10530 by a coupler member 10650. As wasdiscussed above, actuation of the trigger 10460 will result in the axialadvancement of the firing rod 10530 within the elongated shaft assembly4100 to apply firing and retraction motions to the knife bar assembly4600.

Operation of the surgical instrument 4010 will now be described. Toinitiate the closure process, a first stroke is applied to the triggerassembly 10430. That is, the trigger assembly 10430 is initially pivotedtoward the pistol grip 10406. Such pivoting action serves to drive theclosure carriage in the distal direction “DD”. Such distal movement ofthe closure carriage also axially advances the anvil closure rod 4112 inthe distal direction “DD”. As the anvil closure rod 4112 moves distally,the closure link 4120 moves the anvil pin slide 4122 distally. As theanvil pin slide 4122 moves distally, the anvil assembly 4020 is pivotedto the closed position by virtue of the camming interaction of the anvilpin 4034 within the slots 4208, 4126. See FIG. 31 . In the variousmanners discussed herein, if the surgeon desires to simply grasp andmanipulate tissue prior to clamping it between the anvil assembly 4020and the surgical staple cartridge 10030, the trigger assembly 10430 maybe pivoted to open and close the anvil assembly 4020 without fullypivoting the trigger assembly 10430 to the fully closed position. Oncethe trigger assembly 10430 has been initially fully compressed into theclosed position, the anvil assembly 4020 will be retained in the lockedor clamped position by the closure locking assembly which prevents theproximal movement of the closure carriage as was discussed above. Todrive the knife bar assembly 4600 distally through the tissue clamped inthe end effector 4012, the surgeon again pivots the primary trigger10440 toward the pistol grip 10406 of the housing assembly 10400. As theprimary trigger 10440 is pivoted, the firing rack 10500, the firing rod10530, and the knife bar assembly 4600 are driven in the distaldirection “DD”. As the knife bar assembly 4600 is driven in the distaldirection, the cutting head 4610 also moves distally. As the cuttinghead 4610 moves distally, the sloped surface on the upper tab 4616travels up the sloped surfaces 4027 on the distal anvil portion 4022moving the floating distal anvil portion 4022 in the down direction “D”.As the distal anvil portion 4022 is driven downwardly towards theclamped tissue and the staple cartridge 10030, the clamping or crushingaction causes the staples to be formed against the underside of thedistal anvil portion 4022. Thus, as the cutting head 4610 is drivendistally through the end effector 4012, the tissue cutting surface 4620thereon severs the clamped tissue while forming the staples in thestaple cartridge which are situation on both sides of the cut tissue.After the knife bar assembly 4600 has been driven through the tissueclamped in the end effector 4012, the surgeon then releases the primarytrigger 10440 to thereby permit the primary trigger 10440 to pivot toits unactuated position under the bias of the firing spring. As theprimary trigger 10440 pivots back to the starting position, the firingrack 10500, firing rod 10530, and knife bar assembly 4600 are drawnproximally back to their respective starting positions. The end effector4012 remains in its clamped position as shown in FIG. 31 . The anvilassembly 4020 may then be unlocked and moved to the open position in themanner discussed above.

As was discussed in detail above, by having the articulation axis alsobe the axis about which the anvil pivots, the surgeon has a much morereliable frame of reference regarding the location of the pivot axiswhen viewing the endocutter's anvil through the camera. Stated anotherway, when using the end effector arrangement of the surgical instrument10010 the surgeon can determine where the elongated channel is going topivot relative to the elongated shaft by viewing where the anvil ispivotally mounted to the elongated channel.

The surgical instrument 4010 also employs separate control systems formoving the end effector jaws 4013 and 4015. For example, the clinicianmay elect to move or articulate the lower jaw 4013 (elongated channel10014) about the pivot axis A-A toward or way from the upper jaw 4015without actuating the upper jaw 4015 (anvil assembly 4020). This may beaccomplished by actuating the articulation control system 10200 withoutactuating the closure system 4110. Thus, the elongated channel 4014 maybe selectively pivoted about the pivot axis A-A while the anvil assembly4020 is open or closed. Similarly, the anvil assembly 4020 may beactuated or moved without moving the elongated channel 4014 by actuatingthe closure system 4110 without actuating the articulation controlsystem 10200. Such unique and novel arrangement provides the clinicianwith more flexibility when positioning the end effector jaws within thepatient.

FIGS. 36-42 depict another surgical instrument 5010 that is capable ofpracticing several unique benefits of the present invention. Thesurgical instrument 5010 is designed to manipulate and/or actuatevarious forms and sizes of end effectors 5012 that are operably attachedto an elongated shaft assembly 5100 of the surgical instrument. In thedepicted embodiment, for example, the end effector 5012 comprises asurgical stapling device that has openable and closable jaws 5013 and5015. More specifically, the end effector 5012 includes an elongatedchannel 5014 that forms a lower jaw 5013 of the end effector 5012. SeeFIG. 37 . In the illustrated arrangement, the elongated channel 5014 isconfigured to operably support a staple cartridge 10030 of the type andconstruction described herein. For example, the surgical staplecartridge includes a cartridge body 10031 that operably supports aplurality of unformed surgical staples 10032 therein. The elongatedchannel 5014 also movably supports an anvil 3020 that functions as anupper jaw 5015 of the end effector 5012.

In various implementations, the end effector 5012 is configured to becoupled to an elongated shaft assembly 5100 that protrudes from a handleassembly or housing 5400. See FIG. 36 . The handle assembly 5400 may besimilar to one of the handle assemblies disclosed herein and/or in U.S.Patent Application Publication No. 2012/0074200 except for thedifferences discussed below.

Referring to FIG. 38 , the elongated channel 5014 may comprise anelongated trough 5016 that is configured to removably support a surgicalstaple cartridge 10030 thereon. In various implementations, for example,the elongated channel 5014 may be fabricated from, for example, 300 &400 Series, 17-4 & 17-7 stainless steel, titanium, etc. and be formedwith spaced side walls 5018. The body 10031 of staple cartridge 10030 issized to be removably supported within the elongated channel 5014 asshown such that each staple 10032 therein is aligned with correspondingstaple forming pockets in the anvil 5020 when the anvil 5020 is driveninto forming contact with the staple cartridge 10030. The elongatedchannel 5014 may further include a proximal end 5200 that includes apair of spaced side walls 5202 and 5204. Each side wall 5202, 5204 has ahole 5205, 5207, respectively therethrough for attachment to theelongated shaft assembly 5100 by corresponding pivot pins 5310R and5310L.

In at least one implementation, for example, the end effector 5012 isconfigured to be articulated relative to the elongated shaft assembly5100 about an articulation and pivot axis A-A about which the anvilassembly 5020 is pivoted relative to the elongated channel 5014. Theelongated shaft assembly 5100 defines a longitudinal tool axis LT-LT.The articulation and pivot axis A-A is transverse to the longitudinaltool axis LT-LT. The elongated shaft assembly 5100 comprises a hollowouter shaft 5300 and serves to function as the shaft spine of theelongated shaft assembly 5100. The proximal end of the elongated shaftassembly 5100 may be rotatably supported by the handle assembly 5400 sothat the clinician may selectively rotate the elongated shaft assembly5100 and the end effector 5012 attached thereto about the longitudinaltool axis LT-LT. For example, the proximal end of the elongated shaftassembly 5100 may be operably coupled to a nozzle assembly 5250 that isrotatably supported on the handle assembly 5400. Rotation of nozzleassembly 5250 relative to the handle assembly 5400 (represented by arrow“R”) will result in rotation of the elongated shaft assembly 5100 aswell as the end effector 5012 coupled thereto. See FIG. 36 .

Referring again to FIG. 38 , the distal end 5302 of the outer shaft 5300is formed with a clevis arrangement 5304 that comprises a pair of spacedattachment tabs 5306R and 5306L. Each attachment tab 5306R, 5306L has amounting hole 5308R, 5308L, respectively therein that is adapted toreceive a corresponding pivot pin 5310R, 5310L, respectively. Thus, theelongated channel 5014 is selectively pivotable or articulatable aboutthe pivot axis A-A relative to the elongated shaft assembly 5100. Theanvil assembly 5020 includes a distal anvil portion 5022 and a proximalanvil mounting portion 5030. The distal anvil portion 5022 may, for themost part, be substantially coextensive with the portion of theelongated channel 5014 that supports the staple cartridge 10030 and befabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainlesssteel, titanium, etc. The distal anvil portion 5022 comprises two spacedapart anvil portions 5024 that protrude distally from the anvil mountingportion 5030 to define an elongated slot 5026 therebetween. Each of thespaced-apart anvil portions 5024 has a staple forming undersurface,generally labeled as 5028 that has a plurality of staple forming pockets(not shown) formed therein. The anvil mounting portion 5030 includes aright mounting wall 5032 and a left mounting wall 5034. Each mountingwall 5032, 5034 has a mounting hole 5036 extending therethrough that areadapted to pivotally receive therein the corresponding pivot pins 5310R,5310L. Such arrangement serves to pivotally mount the anvil assembly5020 to the elongated channel 5014 for selective pivotal travel aboutpivot axis A-A between an open position and a closed position.

The anvil assembly 5020 is selectively movable between open and closedpositions by means of an anvil bar 5110. The anvil bar 5110 may becoupled to a closure carriage of the type disclosed herein and/or inU.S. Patent Application Publication No. 2012/0074200 such that actuationof a trigger mounted on the handle assembly will result in the axialmovement of the anvil bar 5110 within elongated shaft assembly 5100. Theanvil bar 5110 is configured for movable attachment to an actuator cam5510 that is pivotally journaled on an anvil pin 5038 that protrudesinwardly from the left mounting wall 5034 of the anvil mounting portion5030. See FIGS. 39 and 40 . As can be seen in FIG. 41 , for example, theanvil pin 5034 is rotatably received within a corresponding anvil camslot 5512 within the actuator cam 5510. The distal end 5112 of the anvilbar 5110 is pivotally pinned to the actuator cam 5510 by a pivot pin5114 defines an anvil actuation axis B-B. See FIG. 40 .

The end effector 5012 may also be articulatable or pivotable relative tothe elongated shaft assembly 5100 about the pivot axis A-A by anarticulation system of the type described herein and/or in U.S. PatentApplication Publication No. 2012/0074200. The articulation system may beemployed to axially actuate an articulation bar 5150 that is pivotallycoupled to the actuator cam 5510. Referring to FIGS. 38 and 39 forexample, the distal end 5152 of the articulation bar 5150 pin isrotatably mounted on a pin hub 5514 protruding from the actuator cam5510. The pin hub 5514 has a cavity 5516 therein for rotatably receivingan inwardly protruding channel pin 5209 for selective rotation relativethereto about a channel axis C-C. See FIG. 40 .

FIGS. 41 and 42 illustrate the position of the end effector 5012 in aneutral or unarticulated position with the anvil assembly 5020 thereofin an open position. When the user desires to close the anvil assembly5020, the anvil rod 5110 is advanced distally in the distal direction“DD”. Movement of the anvil rod 5110 in the distal direction causes theactuator cam 5510 to interact with the anvil pin 5038 to pivot the anvilassembly 5020 to a closed position about the pivot axis A-A. When theclinician desires to articulate the end effector 5012, the articulationrod 5150 is moved axially within the elongated shaft 5100. Movement ofthe articulation rod in the distal direction “DD” will, for example,cause the end effector 5012 to pivot in a first direction “FD” that isessentially the same direction in which the anvil assembly 5020 is movedfrom a closed position to an open position (referred to herein as theopening direction “OD”). Movement of the articulation rod in a proximaldirection “PD” will cause the end effector 5012 to pivot in a seconddirection “SD” about the pivot axis A-A which is essentially the samedirection in which the anvil assembly 5020 moves when moving from anopen position to a closed position (referred to herein as the closingdirection “CD”).

As can also be seen in FIGS. 38 and 39 , the surgical instrument 5010further includes a knife bar assembly 5600 that can be attached to thefiring bar and firing rack arrangement disclosed herein and/or in U.S.Patent Application Publication 2012/0074200 such that it can becontrolled by actuating the secondary trigger in the various mannersdescribed herein 460. The knife bar assembly 5600 may comprise a knifebar 5602 that may flex as the end effector 5012 is articulated, whileremaining sufficiently rigid to be driven distally through the shaftassembly 5100. In the depicted embodiment, the knife bar 5602 isattached to a cutting head 5610. In the depicted configuration, thecutting head 5610 includes a vertically oriented body portion 5612 thathas an upper portion 5615 and a lower portion 5617. A bottom foot 5614is formed on or attached to the lower portion 5617. Similarly, an uppertab 5616 is formed on or otherwise attached to the upper portion 5615 ofthe vertically oriented body portion 5612. In addition, as can be seenin FIGS. 38 and 39 , the vertically oriented body portion 5612 furtherincludes a tissue cutting edge 5620. The vertically oriented bodyportion 5612 extends through a longitudinally extending slot 5210 in theelongated channel 5014 and the longitudinally extending slot 5026 in theanvil assembly 5020. Thus, when the cutting head 5610 is distallyadvanced, the upper tab portions 5616 ride on the anvil arms 5024.Likewise the bottom foot 5614 protrudes through a lower opening in theelongated channel 5014 such that it rides below the elongated channel5014 as the cutting head 5610 is advanced distally. As the cutting head5610 is advanced distally, the cutting edge 5620 thereon severs thetissue clamped in the end effector 5012. The surgical staple cartridge10030 is crushed between the anvil assembly 5020 and the elongatedchannel 5014 thereby causing the staples 10032 supported therein to beformed on both sides of the tissue cut line as they are brought intocontact with the staple forming underside of the anvil assembly 5020.After the cutting head 5610 has been advanced to the distal end of theend effector 5012, the user retracts the cutting head 5610 to thestarting position in the manner discussed herein and the trigger isactuated to open the anvil assembly 5020 to release the staple cartridgeand stapled tissue.

As was discussed in detail above, by having the articulation axis alsobe the axis about which the anvil pivots, the surgeon has a much morereliable frame of reference regarding the location of the pivot axiswhen viewing the endocutter's anvil through the camera. Stated anotherway, when using the end effector arrangement of the surgical instrument10010 the surgeon can determine where the elongated channel is going topivot relative to the elongated shaft by viewing where the anvil ispivotally mounted to the elongated channel.

In various implementations, when employing surgical end effectors of thetypes disclosed herein, the end effector is configured to be coupled toan elongated shaft assembly that protrudes from a housing. The housingmay comprise a hand-manipulatable handle arrangement or it may, forexample, comprise a portion of a robotic system or other automatedcontrol system arrangement. The end effector and elongated shaft maytypically be introduced to the surgical site within the patient througha trocar tube or working channel in another form of access instrument.In at least some surgical procedures, it is desirable and indeed, evensometimes necessary, to limit the size of trocar tubes/access tubes thatare employed. This limits the size of end effector and elongated shaftarrangements that may be employed. For example, if a trocar is employedthat has a 5 mm diameter opening through the trocar tube, the endeffector as well as the elongated shaft must be sized to enable them tobe passed through that opening. When employing cutting and stapling endeffectors that essentially comprise jaws that are moveable between openand closed positions, the clinician passes the end effector through thetrocar when the jaws are in their closed position. Typically when thejaws are in their fully closed position, the end effector is in itssmallest cross-sectional shape to facilitate such insertion through thetube or access opening. Once the end effector has been passed throughthe tube or opening, the clinician may then open the jaws to grasp andmanipulate the target tissue. Once the target tissue is properlypositioned between the jaws, the clinician may cause the jaws to beclosed onto or clamped onto the tissue in preparation for firing theinstrument (i.e., causing the instrument to cut and staple the tissue).Thus, the size of the end effector that may be employed to complete asurgical procedure may necessarily be limited by the size of accessopening or access tube that it must pass through. Such limitations canbecome problematic, however, in instances wherein the jaws cannotsufficiently accommodate the target tissue due to the thickness of thetarget tissue to be cut and stapled. In some applications, for example,the tissue may be over compressed by the jaws if the tissue is thickerthan anticipated.

Over the years, a variety of end effector arrangements have beendeveloped to effectively accommodate various tissue thicknesses. Forexample, U.S. Pat. No. 7,665,647, entitled SURGICAL CUTTING AND STAPLINGDEVICE WITH CLOSURE APPARATUS FOR LIMITING MAXIMUM TISSUE COMPRESSION,and issued on Feb. 23, 2010, the entire disclosure of which is herebyincorporated by reference herein discloses cutting head configurationsreferred to as “E-Beam” arrangements that are configured to limit anamount of compression applied to the tissue as the E-beam is fired downthe end effector. While effective, there is a need for an end effectorthat has a fully closed height that is smaller than a closed “operatingheight” or “stapling height” when stapling tissue.

FIGS. 43-46 illustrate a cutting beam assembly 6610 that may be employedwith various end effectors 6012 of the type, for example, disclosedherein as well as those disclosed in U.S. Pat. No. 7,665,647. As can beseen in FIGS. 43 and 44 , the cutting beam assembly 6610 may include afiring bar 6620 that has a proximal portion 6622 that is attached to adistal cutting beam head 6630 that translates within a staple cartridge6670. See FIGS. 45 and 46 . The distal cutting beam head 6630 may alsobe referred to as a “firing member”. The staple cartridge 6670 maycomprise a staple cartridge of the type disclosed in U.S. Pat. No.7,665,647 and be configured to be operably supported in the elongatedchannel 6014 of the end effector 6012. As discussed therein, the staplecartridge 6670 includes a series of staple drivers 6642 that operablysupport the surgical staples 6674 thereon. The drivers 6672 are drivenupwardly toward the anvil 6020 as a wedge sled 6676 is advanced distallythrough the staple cartridge 6670.

Referring to FIGS. 43 and 44 , the distal cutting beam head 6630includes a body portion 6632 that is attached to the proximal portion6622 of the firing bar 6620. The firing bar 6622 may be actuated by anyof the firing arrangements disclosed herein including those firingarrangements disclosed in U.S. Pat. No. 7,665,647. As can be seen inthose Figures, the body portion includes an upper portion 6640 and alower portion 6650. The upper portion 6640 includes a flexible extensionarm 6642 that protrudes from the lower portion 6650. Essentially, theextension arm 6642 comprises a cantilever-type beam arrangement thatincludes a distally protruding nose 6644 that includes upper pins ortabs 6645 that protrude laterally therefrom. The upper portion 6640further includes a lower tab portion 6646 that includes adistally-protruding lower nose portion 6647 and a proximally-protrudinghook, bumper, or catch formation 6648 that is designed to engage acomplementary body hook 6654 formed on the lower portion 6650 as shownin FIG. 44 . As can be most particularly seen in FIGS. 43 and 44 , acutting surface 6649 is provided on the movable upper portion 6640 andis oriented such that it located proximal to the end of the upper nose6644 and the end of the lower nose portion 6647 such that atissue-capturing pocket 6659 is established between the upper nose 6644and the lower nose 6647. Such pocket 6659 enables tissue to be capturedtherein just distal of cutting surface 6649. As can be appreciated fromreference to FIGS. 43 and 44 , the cutting surface 6649 as well as theupper nose portion 6644 and upper tabs 6645 move as a unit (e.g., theymove together) relative to the lower portion 6650 of the cutting beamhead 6630. As will be discussed in further detail below, sucharrangement enables the cutting beam head 6630 to assume a compressedstate that facilitates passage of the cutting beam head 6630 through,for example, an access opening or a trocar port that has a somewhatlimited cross-sectional area, while still being able to accommodatevarious thicknesses of tissue when the end effector has exited thoughthe opening and has been clamped onto the tissue in preparation forfiring.

The lower portion 6650 of the cutting beam head 6630 further includeslower foot tabs 6652 that protrude laterally from the lower portion6650. As can be seen in FIGS. 45 and 46 , the elongated channel 6014includes an elongated slot 6016 that corresponds with an elongated slot6678 in the staple cartridge 6670 for accommodating the body portion6632 of the cutting beam head 6630. The elongated channel further has achannel track 6018 that is configured to receive the lower foot tabs6652. Likewise, the anvil assembly 6020 includes an elongated slot 6022that accommodates the body portion 6632 and an upper anvil track 6024that accommodates the upper tabs 6645 therein.

FIG. 43 illustrates the cutting beam head 6630 in its compressed state.The overall maximum height of the cutting beam head in this compressedstate is represented by “H1”. FIG. 44 illustrates the cutting beam head6630 in its uncompressed maximum height state. The overall maximumheight of the cutting beam head in this uncompressed state isrepresented by “H2”. It will be understood that the overall height ofthe E-beam 6630 can vary between H1 and H2 depending upon the cuttingbeam head's compressed state. Referring now to FIG. 45 , the endeffector 6012 is illustrated in its most cross-sectionally compact statewhich may be referred to herein as its insertion state or position. Theoverall height (or diameter) of the end effector 6012 is represented inFIG. 45 by “E1”. This would be the state, for example, in which the endeffector 6012 might be inserted through an access opening or a trocarport. Once the end effector 6012 has been inserted through the openingor trocar port to the surgical site, the clinician may open and closethe anvil assembly 6020 as needed to grasp and manipulate the targettissue T. Once the target tissue T has been captured between the anvilassembly 6020 and the staple cartridge 6670, the clinician may lock theanvil assembly 6020 in the closed position in the various mannersdisclosed herein or otherwise known. The unique and novel cutting beamhead 6630 enables the overall height of the end effector 6012 toincrease to accommodate various thicknesses of tissue and or differentsurgical staple cartridges that have different lengths/sizes ofstaples/fasteners. FIG. 46 illustrates the target tissue T after it hasbeen “fully clamped” in the end effector 6012 and the end effector 6012has been fired to cut and sever the tissue T. The overall height of theend effector 6012 is represented by “E2”. Such cutting beam headarrangement is capable of assuming a compressed insertion height forinsertion into the surgical site and then automatically reconfiguring toa firing height. Such reconfiguration is accomplished by the extensionarm 6642 which acts as a spring and which is normally biased into itsuncompressed state as illustrated in FIG. 44 . Thus, the cutting beamhead 6630 has a range of operating heights extending between H1 and H2.This range may be represented by “H3” and may be equal to the distancebetween the lower edge of the extension arm 6642 and the upper-most edgeof the body hook portion 6636. See FIG. 44 .

FIGS. 47-54 depict another surgical instrument 7010 that is capable ofpracticing several unique benefits of the present invention. Thesurgical instrument 7010 depicted in the FIG. 47 comprises a housing7020 that consists of a handle 7022 that is configured to be grasped,manipulated and actuated by a clinician. The handle 7022 may comprise apair of interconnectable housing segments 7024, 7026 that may beinterconnected by screws, snap features, adhesive, etc. As the presentDetailed Description proceeds, however, it will be understood that thevarious unique and novel arrangements of the various forms of shaftarrangements and end effector arrangements disclosed herein may also beeffectively employed in connection with robotically-controlled surgicalsystems such as those robotic systems and arrangements disclosed in U.S.patent application Ser. No. 13/536,323, entitled ROBOTICALLY POWEREDSURGICAL DEVICE WITH MANUALLY ACTUATABLE REVERSING SYSTEM, and filedJun. 28, 2012, now U.S. Pat. No. 9,408,606, the entire disclosure ofwhich is has been herein incorporated by reference.

As can be seen in FIG. 48 , the surgical end effector 7100 may comprisean elongated channel 7102 that is configured to receive a surgicalfastener cartridge 7110 therein. The surgical fastener cartridge 7110may include a cartridge body 7112 that has a centrally disposedelongated slot 7114 therein. The cartridge body 7112 may further includerows of fastener pockets 7116 that are located on each side of theelongated slot 7114 and which are configured to support correspondingsurgical fasteners 7120 therein. The elongated channel 7102 may furtheroperably support a “firing member” in the form of a tissue-cuttingmember or knife assembly 7150. The knife assembly 7150 is configured toaxially travel in the slot 7114 in the cartridge body 7112 when thecartridge body 7112 has been installed in the elongated channel 7102.The knife assembly 7150 may be configured with a tissue cutting edge7152 that is centrally disposed between a lower foot 7154 and an upperfoot or tab 7156. In a preferred arrangement, the knife assembly 7150has the same construction and features as cutting head assembly 6610described in detail above. As will be discussed in further detail below,the knife assembly 7150 is configured to be axially driven within theelongated channel 7102 and the surgical fastener cartridge 7110 inresponse to motions applied thereto by a firing drive system 7300.

As can also be seen in FIG. 48 , the surgical end effector 7100 mayfurther include an anvil assembly 7130 that is supported for movementrelative to the elongated channel 7102. The anvil assembly 7130 may bemovable relative to the surgical fastener cartridge 7110, for example,in response to “actuation motions” which may comprise, for example,closing and opening motions that are transferred thereto from a closuredrive system 7200. In one arrangement, for example, the anvil assembly7130 includes an anvil body portion 7132 that has a fastener formingsurface 7134 formed on the underside thereof. The fastener formingsurface 7134 may comprise a series of forming pockets (not shown) thatcorrespond to the surgical fasteners 7120 supported in the surgicalfastener cartridge 7110. As the legs of the surgical fasteners 7120 aredriven into forming contact with the corresponding forming pockets inthe anvil assembly 7130, they are formed into a desired tissue-retainingconfiguration. The anvil assembly 7130 may further includes an anvilmounting portion 7136 that has a pair of trunnions 7138 protrudingtherefrom that are received within corresponding trunnion slots 7610formed in a U-shaped control insert 7602 that is movably supported in aproximal mounting portion 7104 of the elongated channel 7102. In variousarrangements, the surgical fasteners 7120 are driven out of theirrespective fastener pockets 7116 in the surgical fastener cartridge 7110by corresponding sled assemblies 7160 and 7170 that are movablysupported within the elongated channel 7102 and are movable in responseto firing motions applied thereto by the firing drive system 7300.

As indicated above, the anvil assembly 7130 is also responsive toactuation motions in the form of opening and closing motions that areapplied thereto by a closure drive system 7200. Various detailsregarding the certain aspects of the construction and operation of theclosure drive system 7200 may be found in U.S. patent application Ser.No. 13/803,097, filed Mar. 14, 2013, and entitled ARTICULATABLE SURGICALINSTRUMENT COMPRISING A FIRING DRIVE, now U.S. Pat. No. 9,687,230, theentire disclosure of which is incorporated by reference herein. Asdiscussed in that reference and as shown in FIG. 49 herein, the closuredrive system 7200 includes a closure trigger 7202 that is configured tocooperate with a closure release assembly 7220 that is pivotally coupledto a frame 7030. In at least one form, the closure release assembly 7220may comprise a release button assembly 7222 that may be pivoted in acounterclockwise direction by a release spring (not shown). As theclinician depresses the closure trigger 7202 from its unactuatedposition towards the pistol grip portion 7028 of the handle 7022, theclosure release assembly 7220 serves to lock the closure trigger 7202 inthe fully actuated position. When the clinician desires to unlock theclosure trigger 7202 to permit it to be biased to the unactuatedposition, the clinician simply pivots the closure release buttonassembly 7220 to cause it to disengage the closure trigger arrangementand thereby permit the closure trigger 7202 to pivot back to theunactuated position. Other closure trigger locking and releasearrangements may also be employed.

Referring to FIGS. 49-50 , the closure drive system 7200 may furthercomprise a proximal closure tube segment 7210 that has a proximal end7212 that is adapted to be rotatably coupled to a closure tubeattachment yoke 7230. The proximal end 7212 of the proximal closure tubesegment 7210 is configured to be received within a cradle 7232 (FIG. 49) in the closure tube attachment yoke 7230 to permit relative rotationrelative thereto. The proximal closure tube segment 7210 may berotatably attached to the closure tube attachment yoke 7230 by aU-shaped connector (not shown) that is configured to be received in anannular slot 7214 in the proximal end 7212 of the proximal closure tubesegment 7210 and be seated in a slot 7234 (FIG. 49 ) in the closure tubeattachment yoke 7230. Such arrangement serves to rotatably couple theproximal closure tube segment 7210 to the closure tube attachment yoke7230 such that the proximal closure tube segment 7210 may rotaterelative thereto. More specifically, such arrangement facilitates manualrotation of the elongated shaft assembly 7050 relative to the handle7022 about a longitudinal tool axis “LT-LT” defined by the elongatedshaft assembly 7050 to enable the clinician to rotate the surgical endeffector 7100 in the manner represented by arrow “R” in FIG. 47 .

In various arrangements, the closure tube attachment yoke 7230 ismovably mounted on a proximal articulation tube 7402 of an articulationsystem 7400 which will be discussed in further detail below. Sucharrangement permits the closure tube attachment yoke 7230 to moveaxially on the proximal articulation tube 7402 in response to actuationof the closure trigger 7202. In particular, the closure tube attachmentyoke 7230 may be pivotally coupled to the closure trigger 7202 by aclosure linkage bar 7240. See FIG. 49 . Thus, when the clinician pivotsthe closure trigger 7202 inward toward the pistol grip portion 7028 ofthe handle 7022, the closure tube attachment yoke 70230 will be advancedin the distal direction “DD”. When the firing trigger 7202 is returnedto the unactuated position, the closure tube attachment yoke 7230 willbe advanced proximally (direction “PD”) on the proximal articulationtube 7402 to a starting position.

The closure drive system 7200 may further include an intermediate tubesegment 7250 that is configured for attachment to the distal end 7218 ofthe proximal closure tube segment 7210. As can be seen in FIG. 50 , theintermediate tube segment 7250 may include a flexible articulationportion 7260 and an attachment stem portion 7252. The attachment stemportion 7252 may be sized to extend into the open distal end 7218 of theproximal closure tube segment 7210 in frictional engagement therewith.The flexible articulation portion 7260 may be integrally formed with theattachment stem portion 7252 and include an articulation spine 7262 thatincludes proximal end portions 7264 (only one can be seen in FIG. 50 )that are configured to be received in corresponding notches 7219 in thedistal end 7218 of the proximal closure tube segment 7210 to preventrelative rotation between the proximal closure tube segment 7210 and theintermediate tube segment 7250. The intermediate tube segment 7250 maybe non-rotatably (i.e., attached to prevent relative rotation betweenthese components) attached to the proximal closure tube segment 7210 by,for example, screws, detents, adhesive, etc.

The closure drive system 7200 may further include a distal closure tubesegment 7280 that is configured to axially engage and apply opening andclosing motions to the anvil assembly 7130. The distal closure tubesegment 7280 may be attached to the distal end of intermediate tubesegment 7250 for axial travel therewith. The articulation spine 7262 mayfurther include distal end portions 7266 that are configured to bereceived in corresponding notches 7284 in the proximal end 7282 of thedistal closure tube segment 7280 to prevent relative rotation betweenthe distal closure tube segment 7280 and the intermediate tube segment7250. See FIG. 50 . The proximal end 7282 of the distal closure tubesegment 7280 may inwardly extending attachment tabs 7286 that areadapted to be bent into corresponding notches 7266 in the intermediatetube segment 7250. See FIG. 50 . Such arrangement serves to facilitateattachment of the distal closure tube segment 7280 to the intermediatetube segment 7250 for axial travel therewith.

The distal closure tube segment 7280 is configured to apply opening andclosing motions to the anvil assembly 7130. The anvil mounting portion7136 may be formed with an anvil tab 7142. The distal end 7288 of thedistal closure tube segment 7280 has an inwardly extending actuation tab7290 formed therein that is configured to interact with the anvil tab7142. For example, when the distal closure tube segment 7280 is in theopen position, the actuation tab 7290 is in biasing contact with theanvil tab 7142 which serves to pivot the anvil assembly 7130 to the openposition.

Operation of the closure drive system 7200 will now be described. Theanvil assembly 7130 may be moved relative to the surgical fastenercartridge 7110 by pivoting the closure trigger 7202 toward and away fromthe pistol grip portion 7028 of the handle 7022. Thus, actuating theclosure trigger 7202 causes the proximal closure tube segment 7210, theintermediate tube segment 7250 and the distal closure tube segment 7280to move axially in the distal direction “DD” to contact the end wall7144 of the anvil body portion 7132 to pivot or otherwise move the anvilassembly 7130 toward the surgical fastener cartridge 7110. The clinicianmay grasp and manipulate tissue between the anvil assembly 7130 and thefastener cartridge 7110 by opening and closing the anvil assembly 7130.Once the target tissue is captured between the anvil assembly 7130 andfastener cartridge 7110, the clinician may pivot the closure trigger7202 to the fully actuated position wherein it is locked in place forfiring.

Referring again to FIG. 49 , the frame 7030 may also be configured tooperably support the firing drive system 7300 that is configured toapply firing motions to corresponding portions of the elongated shaftassembly 7050 and ultimately to the knife assembly 7150 and the sledassemblies 7160, 7170. As can be seen in FIG. 49 , the firing drivesystem 7300 may employ an electric motor 7302 that is supported in thepistol grip portion 7028 of the handle 7022. In various forms, the motor7302 may be a DC brushed driving motor having a maximum rotation of,approximately, 25,000 RPM, for example. In other arrangements, the motor7302 may include a brushless motor, a cordless motor, a synchronousmotor, a stepper motor, or any other suitable electric motor. A battery7304 (or “power source” or “power pack”), such as a Li ion battery, forexample, may be coupled to the handle 7022 to supply power to a controlcircuit board assembly 7306 and ultimately to the motor 7302.

The electric motor 7302 can include a rotatable shaft 7308 that operablyinterfaces with a gear reducer assembly 7310 that is mounted in meshingengagement with a with a set, or rack, of drive teeth 7322 on alongitudinally-movable drive member 7320. The gear reducer assembly 7310can include, among other things, a housing and an output pinion gear7314. In certain embodiments, the output pinion gear 7314 can bedirectly operably engaged with the longitudinally-movable drive member7320 or, alternatively, operably engaged with the drive member 7320 viaone or more intermediate gears. In use, the electric motor 7302 can movethe drive member distally, indicated by an arrow “DD”, and/orproximally, indicated by an arrow “PD”, depending on the direction inwhich the electric motor 7302 rotates. For example, a voltage polarityprovided by the battery can operate the electric motor 7302 in aclockwise direction wherein the voltage polarity applied to the electricmotor by the battery can be reversed in order to operate the electricmotor 7302 in a counter-clockwise direction. When the electric motor7302 is rotated in one direction, the drive member 7320 will be axiallydriven in the distal direction “DD”. When the motor 7302 is driven inthe opposite rotary direction, the drive member 320 will be axiallydriven in a proximal direction “PD”. The handle 7022 can include aswitch which can be configured to reverse the polarity applied to theelectric motor 7302 by the battery. The handle 7022 can also include asensor that is configured to detect the position of the movable drivemember 7320 and/or the direction in which the movable drive member 7320is being moved.

Actuation of the motor 7302 can be controlled by a firing trigger 7330that is pivotally supported on the handle 7022. The firing trigger 7330may be pivoted between an unactuated position and an actuated position.The firing trigger 7330 may be biased into the unactuated position by aspring (not shown) or other biasing arrangement such that when theclinician releases the firing trigger 7330, it may be pivoted orotherwise returned to the unactuated position by the spring or biasingarrangement. In at least one form, the firing trigger 7330 can bepositioned “outboard” of the closure trigger 7202 as discussed infurther detail in U.S. patent application Ser. No. 13/803,097, now U.S.Pat. No. 9,687,230, which has been previously incorporated by referencein its entirety herein. In at least one form, a firing trigger safetybutton 7332 may be pivotally mounted to the closure trigger 7202. Thesafety button 7332 may be positioned between the firing trigger 7330 andthe closure trigger 7202 and have a pivot arm (not shown) protrudingtherefrom. When the closure trigger 7202 is in the unactuated position,the safety button 7332 is contained in the handle housing where theclinician cannot readily access it and move it between a safety positionpreventing actuation of the firing trigger 7330 and a firing positionwherein the firing trigger 7330 may be fired. As the clinician depressesthe closure trigger 7202, the safety button 7332 and the firing trigger7330 pivot down to a position wherein they can then be manipulated bythe clinician.

As indicated above, in at least one form, the longitudinally movabledrive member 7320 has a rack of teeth 7322 formed thereon for meshingengagement with a corresponding drive gear of the gear reducer assembly7310. At least one form may also include a manually-actuatable “bailout”assembly that is configured to enable the clinician to manually retractthe longitudinally movable drive member 7320 should the motor becomedisabled. U.S. patent application Ser. No. 13/803,097, now U.S. Pat. No.9,687,230, contains further details of one form of bailout assembly thatmay be employed. U.S. Patent Application Publication No. 2010/0089970,now U.S. Pat. No. 8,608,045, also discloses “bailout” arrangements andother components, arrangements and systems that may also be employedwith the various instruments disclosed herein. U.S. patent applicationSer. No. 12/249,117, entitled POWERED SURGICAL CUTTING AND STAPLINGAPPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, filed on Oct. 10,2008, now U.S. Pat. No. 8,608,045, is incorporated by reference in itsentirety.

Referring to FIG. 50 , various forms of the elongated shaft assembly7050 may include a firing member assembly 7060 that is supported foraxial travel within an articulation shaft assembly 7400 that essentiallyfunctions as shaft frame or spine. The firing member assembly 7060 mayfurther include a proximal firing shaft 7062 that has a proximal endportion 7064 that is configured to be rotatably received in a distalcradle 7326 provided in a distal end 7324 of the movable drive member7320. Such arrangement permits the proximal firing shaft 7062 to rotaterelative to the movable drive member 7320 while also axially movingtherewith. The proximal firing shaft 7062 may further have a slot 7068formed in its distal end for receiving a proximal end 7072 of a flexibledistal firing shaft assembly 7070 therein. See FIG. 50 . As can be seenin that Figure, the proximal end 7072 of the distal firing shaftassembly 7070 may be received within the slot 7068 in the distal firingshaft 7062 and may be pinned thereto with a pin 7073.

The distal firing shaft assembly 7070 may include a central firing beam7074 that is located between a right sled pusher beam 7076 and a leftsled pusher beam 7078. The central firing beam 7074 and the pusher beams7076, 7078 may, for example, each be fabricated from metal thatfacilitates axial actuation of the sled assemblies 7160, 7170 in thesurgical end effector 7100 while also facilitating flexing thereof whenthe end effector 7100 is articulated. In at least one arrangement, thecentral pusher beam 7074, the right sled pusher beam 7076 and the leftsled pusher beam 7078 may extend through a slot 7146 in the anvilmounting portion 7136. The right sled pusher beam 7076 corresponds tothe right sled assembly 7160 and the left sled pusher beam 7078corresponds to the left sled assembly 7170 movably supported within theelongated channel 7102. Axial movement of the right sled pusher beam7076 and the left sled pusher beam 7078 will result in the axialadvancement of the right and left sled assemblies 7160, 7170,respectively, within the elongate channel 7102. As the right sledassembly 7160 is axially advanced within the elongated channel 7102, itdrives the surgical fasteners 7120 supported in the cartridge body 7112on the right side of the slot 7114 out of their respective pockets 7116and as the left sled assembly 7170 is axially advanced within theelongated channel 7102, it drives the surgical fasteners 7120 supportedwithin the cartridge body 7112 on the left side of the slot 7114 out oftheir respective pockets 7116.

The central firing beam 7074 has a distal end 7080 that may beconfigured to be received within a slot 7151 provided in the bodyportion of the knife assembly 7154 and retained therein by, for example,a frictional fit, adhesive, welding, etc. In at least one form, theelongated channel 7102 is formed with a right upstanding wall 7107 and aleft upstanding wall 7108 that define a centrally-disposed channel slot7109. Once the knife assembly 7150 is inserted into the bottom window inthe elongated channel 7102, the body portion of the knife assembly 7150may be inserted into the channel slot 7109 and advanced proximally inthe elongated channel 7102 to be coupled with the distal end 7080 of thecentral firing beam 7074. A lower channel cover 7111 may be attached tothe bottom of the elongated channel 7102 to prevent tissue, body fluids,etc. from entering into the elongated channel 7102 which might hamperthe movement of the knife assembly 7150 therein.

The surgical instrument 7010 may also include an articulation system7400 of the type described in detail in U.S. patent application Ser. No.13/803,097, now U.S. Pat. No. 9,687,230. In one implementation, forexample, the articulation system 7400 includes an articulation shaftassembly 7430 that may be operably controlled by an articulation controlsystem 7460. In one form, for example, the articulation shaft assembly7430 may include a right articulation shaft segment 7440 and a leftarticulation shaft segment 7450. The right articulation shaft segment7440 includes a proximal end 7442 that has a right passage segment 7444formed therein. Likewise the left articulation shaft segment 7450includes a proximal end portion 7452 that has a left passage segment7454 formed therein. When the right articulation shaft segment 7440 andthe left articulation shaft segment 7450 are installed within theproximal closure tube segment 7210, they form the articulation shaftassembly 7430. The right passage segment 7444 and the left passagesegment 7454 cooperate to receive a portion of the proximal firing shaft762 therein. The right articulation shaft segment 7440 and the leftarticulation shaft segment 7450 may be, for example, composed of aplastic, especially a glass fiber-reinforced amorphous polyamide, soldcommercially under the trade name Grivory GV-6H by EMS-American Grilon.

Still referring to FIG. 50 , the articulation shaft assembly 7430 mayfurther include a right articulation band 7490 and a left articulationband 7500. In one form, a proximal end portion 7492 of the rightarticulation band 7490 may be attached to a distal portion 7448 of theright articulation shaft segment such that a distal portion 7494 of theright articulation band 7490 protrudes out of a right passage 7449therein. The proximal end portion 7492 of the right articulation band7490 may include holes or cavities 7493 that are configured to receivecorresponding lugs (not shown) in the right articulation shaft segment7440 to facilitate attachment of the right articulation band 7490 to theright articulation shaft segment 7440. Likewise, a proximal end portion7502 of the left articulation band 7500 may have holes or cavities 7503therein that are configured to receive lugs (not shown) in the distalportion 7458 of the left articulation shaft segment 7450 to facilitateattachment of the left articulation band 7500 to the articulation shaftsegment 7450. The articulation bands 7490 and 5700 may be composed of ametal, advantageously full hard 301 stainless steel or its equivalent.The distal end of the left articulation band 7500 may have a left hookportion 7506 that is adapted to be coupled to a left attachment portion7507 of the elongated channel 7102. Likewise, the distal end of theright articulation band 7494 has a right hook portion 7496 forattachment to a right attachment portion 7497. As discussed in furtherdetail in U.S. patent application Ser. No. 13/803,097, now U.S. Pat. No.9,687,230, when the clinician wishes to articulate the end effector 7100to the right relative to the longitudinal tool axis LT-LT, the cliniciansimply rotates the articulation control knob 7570 in the appropriatedirection.

The surgical instrument 7010 may be used in a minimally invasiveprocedure wherein it is inserted through a trocar port that has beeninstalled in a patient. In such applications, it is generallyadvantageous to minimize the overall cross-sectional shape of the endeffector during insertion into the patient in order to minimize the sizeof the trocar port that must be employed. The smallest cross-sectionalconfiguration that the end effector 7100 may adopt is achieved when theupper jaw or anvil assembly 7130 is in its a “first insertion position”relative to the lower jaw or more specifically relative to the surgicalstaple cartridge 7110 installed in the elongated channel 7102. Thus, tofacilitate insertion of the end effector 7100 through the trocar port,the cross-sectional area or footprint is sized relative to thecross-sectional size of the port opening in the trocar port to permitthe end effector 7110 to slidably pass therethrough.

In at least one implementation, the end effector 7100 employs an activeanvil control system 7600 that is configured to enable the anvilassembly 7130 to move to the first insertion position to enable the endeffector 7100 to be inserted through the trocar port and then once theend effector 7100 has passed through the trocar port, enables the anvilassembly 7130 to assume an operating configuration for stapling tissue.Referring to FIGS. 48 and 51-54 , one form of anvil control system 7600includes a U-shaped control insert 7602 that is movably supported on theelongated channel 7102 and is attached to a control bar 7604. Thecontrol bar 7604 extends through the elongated shaft assembly 7050 andis movably supported for axial travel therein. The control bar 7604 maybe attached to a movable actuator slide 7606 or other form of actuatorarrangement supported on the handle assembly. See FIG. 47 . Movement ofthe actuator slide 7606 in the distal direction “DD” will cause thecontrol bar 7604 to move in the distal direction “DD”. Similarly,movement of the actuator slide 7606 in the proximal direction “PD” willcause the control bar 7604 to move in the proximal direction “PD”.

As can be seen in FIG. 48 , the U-shaped control insert 7602 is formedwith two upstanding walls 7608 that each have a somewhat L-shapedtrunnion slot 7610 therein. More specifically, each trunnion slot 7610has a vertical slot portion 7612 and a horizontal slot portion 7614. Thetrunnion slots 7610 are sized to movably receive a corresponding anviltrunnion 7138 therein. FIG. 51 illustrates the anvil assembly 7130 inits first insertion position. As can be seen in that Figure, forexample, the anvil assembly 7130 is being inserted through a distal endportion of a trocar port 7630. To enable the anvil assembly 7130 toassume that first insertion position, the clinician moves the controlbar 7604 in the distal direction “DD” to cause the movable anviltrunnions 7130 to be retained within the horizontal slot portions 7614as shown. When in that position, the anvil mounting portion 7136 is inis lowest position within the elongated channel 7102.

The elongated channel 7102 is equipped with an elastic “biasing means”7620 that serves to bias the anvil body portion 7132 away from theelongated channel 7102. In various embodiments, the elastic biasingmeans 7620 may comprise any form of resilient member(s) and/or spring(s)that are attached directly to the elongated channel 7102. For example,in the depicted arrangement, the biasing means comprises strips ofcompressible or elastic foam material 7622 attached along the sides ofthe elongated channel 7102. When the anvil assembly 7130 is inside thetrocar port 7630, the foam strips 7622 will be compressed as shown inFIG. 51 . After the end effector 7100 has passed through the trocar port7630, the clinician may move the control bar 7604 in the proximaldirection “PD” such that the control insert 7602 is also movedproximally to the position illustrated in FIG. 52 . When in thatposition, the foam strips 7622 bias the anvil assembly 7130 upward(represented by arrow “U” in FIG. 52 ) to a “primary opened position”thereby causing the anvil trunnions 7138 to move to the upper end of thevertical trunnion slots 7612 as shown. When the anvil assembly 7130 isin that “primary opened position”, the clinician may then actuate theclosure trigger to move the distal closure tube 7280 in the proximaldirection “PD” to cause the anvil assembly 7130 to move to a “fully openposition” as illustrated in FIG. 53 . Once the clinician has positionedthe target tissue between the anvil assembly 7130 and the staplecartridge 7110, the anvil assembly 7130 can be closed using the closuretrigger 7202 to move the anvil assembly 7130 to the closed or fullyclamped position illustrated in FIG. 54 .

FIGS. 55 and 56 illustrates a “passive” anvil control arrangement 7650that is configured to enable the anvil assembly 7130 to move to thefirst insertion position for insertion through a hollow trocar port 7630and then, once the end effector 7100 has passed through the hollowtrocar port 7630, to be biased into a “primary opened position”whereupon further actuation motions may be applied to the anvil assembly7130 for acquiring and clamping the target tissue. In this arrangement,for example, the anvil control arrangement 7650 includes a U-shapedcontrol insert 7652 that is movably supported on the elongated channel7102 for vertical travel therein. One form of control insert 7652 isdepicted in FIG. 57 . As can be seen in that Figure, the control insertincludes a pair of vertical side walls 7654 that are spaced from eachother and connected together by an upper bar 7655. Each vertical sidewall has an arcuate trunnion slot 7656 therein. Referring again to FIGS.55 and 56 , the control insert 7652 is movable relative to the elongatedchannel 7102 along an insert axis “IA-IA” which is transverse to thelongitudinal tool axis “LT-LT” that is defined by the elongated shaftassembly 7050. The control insert 7652 may movably interface withvertically extending guide ribs 7660 formed in the elongated channel7102 to guide the control insert 7652 as it moves up and down along theinsert axis IA-IA between a first lower position that corresponds to theinsert position of the anvil assembly 7130 and a second upper positionthat corresponds to the “primary opened position” wherein actuationmotions may be applied to the anvil assembly 7130. As can be seen inFIGS. 55 and 56 , the anvil trunnions 7138 are received within thetrunnion slots 7656. Control member biasing means 7662 is providedbetween the control insert 7652 and the bottom of the elongated channel7102 to bias the control insert 7652 in the upward direction “U” to thesecond or upper-most position. As shown in FIG. 55 , the control memberbiasing means 7662 comprises leaf springs 7664. However, other biasingmaterials, members, springs, materials, etc. may be employed.

FIG. 55 illustrates the end effector 7100 wherein the upper jaw or anvilassembly 7130 is in the insertion position as it is being and beinginserted through the trocar port 7630. As can be seen in that Figure,the control insert 7652 is compressed into its lowest position withinthe elongated channel 7102 referred to herein as the first position.After the end effector 7100 has been inserted through the trocar port7630, the “biasing means” 7620 serves to bias the anvil body portion7132 away from the elongated channel 7102 to the primary opened positionas shown in FIG. 56 . As can be seen in that Figure, when the anvilassembly 7130 is in that position, the springs 7664 bias the controlinsert 7652 to its upper-most or second position and the clinician maythen operate the closure system to apply an actuation motion to theanvil assembly 7130 to move the anvil assembly 7130 relative to theelongated channel 7102 to a fully opened position for receiving thetarget tissue therebetween. The clinician may then again operate theclosure system to move the anvil assembly to the fully clamped positionwherein the end effector is ready for firing.

FIGS. 58 and 59 illustrate another anvil control configuration thatfacilitates initial positioning of the anvil assembly in a fullycompressed, first insertion position wherein the end effector 7720 canbe inserted through the trocar port and then once the end effector 7100has passed through the trocar port, enables the anvil assembly 7730 toassume a primary opened position whereupon application of an actuationmotion to the anvil assembly 7730 may cause the anvil assembly 7730 tomove to a fully opened position. As shown in those Figures, the endeffector 7720 is coupled to a surgical instrument 7710 of the types andconstruction disclosed herein. The anvil assembly 7730 may be similar inconstruction to other anvil assemblies disclosed herein. For example,the anvil assembly 7730 may include an anvil body portion 7732 and ananvil mounting portion 7736 that has a pair of trunnions 7738 protrudingtherefrom as well as an upstanding anvil tab 7742. The anvil tab 7742 isconfigured to interact with the actuation tab 7290 of the distal closuretube segment 7280 has in the various manners described herein.

As can be seen in FIGS. 58 and 59 , the end effector 7720 includes anelongated channel 7721 that is similar in construction and operation toother elongated channel arrangements described herein. The elongatedchannel 7721 is configured to operably support a surgical staplecartridge therein and includes a proximal mounting portion 7722 thatcomprises two upstanding wall portions 7723 that each has a trunnionslot 7724 therein. In at least one implementation, each trunnion slot7724 has a distal portion 7726 that allows the trunnions to be parkedtherein during the initial insertion process. Each trunnion slot 774further has an arcuate portion 7727 that facilitates travel of thetrunnions 7738 during opening and closing of the anvil assembly 7730.

In various implementations, biasing means 7750 are provided on portionsof the underside 7733 of the anvil body portion 7732 as well as on thesides of the elongated channel 7721 and/or on portions of the surgicalstaple cartridge. For example, anvil biasing member(s) 7752 may beprovided on the anvil body portion 7732 in confronting arrangement withanvil biasing member(s) 7756 on the elongated channel 7721. The biasingmeans 7752, 7754 may comprise any form of resilient member(s) and/orspring(s). For example, in the depicted arrangement, the biasing meanscomprises strips of compressible or elastic foam material. When theanvil assembly 7730 is inside the trocar port 7630, the biasing members7752, 7754 will be compressed as shown in FIG. 58 . After the endeffector 7720 has passed through the trocar port 7630, the biasingmembers 7752, 7754 bias the anvil assembly 7730 upward to a “primaryopened position” as shown in FIG. 59 . When the anvil assembly 7730 isin that “primary opened position”, the clinician may then actuate theclosure trigger to move the distal closure tube 7280 in the proximaldirection “PD” to cause the anvil assembly 7730 to move to a “fully openposition”. Once the clinician has positioned the target tissue betweenthe anvil assembly 7730 and the staple cartridge, the anvil assembly7730 can be moved to the closed or fully clamped position. The amount ofresistance and biasing forces generated by the biasing members may bealtered by employing different biasing members having differentdurometers or spring members with different spring compressioncharacteristics. Another method is to alter the geometry of the biasingmembers. FIGS. 60 and 61 depict different biasing member configurations7752′, 7754′ (FIG. 60 ) and 7752″, 7754″ (FIG. 61 ).

FIGS. 62 and 63 illustrate use of the end effector 7720 with analternative distal closure tube arrangement 7280′ that is essentiallyidentical as distal closure tube 7280 except that a biasing member 7292is mounted on the inwardly extending actuation tab 7290. In theillustrated embodiment, the biasing member 7292 comprises a leaf-typespring. It will be appreciated however, that the biasing member couldcomprise an elastic material that is attached, for example, to the anvilmounting portion 7736 (distal from the anvil tab 7742). FIG. 62illustrates the end effector 7720 the insertion position as it is beinginserted through the trocar port 7630. As can be seen in that Figure,the anvil body portion 7732 is compressed into its lowest positionrelative to the elongated channel 7102 by trocar portion 7630 which alsoplaces a biasing force or motion on the biasing member 7292. After theend effector 7100 has been inserted through the trocar port 7630, thebiasing member 7292 biases the anvil body portion 7132 away from theelongated channel 7102 to the primary opened position as shown in FIG.63 . The clinician may then again operate the closure system to move theanvil assembly 7730 to the fully clamped position wherein the endeffector is ready for firing.

FIG. 64 illustrates an exemplary surgical instrument 7810 which caninclude a housing 7820, an elongated shaft assembly 7850 that operablyprotrudes from the housing 7820 and which is operably coupled to asurgical end effector 7900. The surgical instrument 7810 depicted in theFIG. 64 comprises a housing 7820 that consists of a handle 7822 that isconfigured to be grasped, manipulated and actuated by a clinician. Asthe present Detailed Description proceeds, however, it will beunderstood that the various unique and novel arrangements of the variousforms of shaft arrangements and end effector arrangements disclosedherein may also be effectively employed in connection withrobotically-controlled surgical systems. Thus, the term “housing” mayalso encompass a housing or similar portion of a robotic system thathouses or otherwise operably supports at least one drive system that isconfigured to generate and apply at least one control motion which couldbe used to actuate various forms of surgical end effectors attachedthereto. The term “frame” may refer to a portion of a handheld surgicalinstrument. The term “frame” may also represent a portion of arobotically controlled surgical instrument and/or a portion of therobotic system that may be used to operably control a surgicalinstrument. For example, U.S. patent application Ser. No. 13/536,323,entitled ROBOTICALLY POWERED SURGICAL DEVICE WITH MANUALLY ACTUATABLEREVERSING SYSTEM, filed Jun. 28, 2012, now U.S. Pat. No. 9,408,606, theentire disclosure of which is incorporated by reference herein disclosesvarious robotic system arrangements that may also be effectivelyemployed. Furthermore, as will be discussed in further detail below, thesurgical instrument 7810 depicted in at least some of the accompanyingdrawings employs a motor for generating control motions for actuatingvarious components and features of the surgical end effector. As thepresent Detailed Description proceeds, however, those of ordinary skillin the art will appreciate that certain features and advantages of thepresent invention may also be effectively attained in connection withsurgical instruments that are equipped with manually generated (i.e.,non-motor generated) actuation and control motions.

As illustrated in FIGS. 64 and 66 , the handle 7822 may comprise a pairof interconnectable housing segments 7824, 7826 that may beinterconnected by screws, snap features, adhesive, etc. As used herein,the term “snap feature” includes, but is not limited to, for example, atab that has a protrusion thereon that is configured to retaininglyengage a corresponding mating portion of another component. Suchfeatures may be designed to releasably engage the mating portion or itmay not be designed or intended to be removed. In the illustratedarrangement, the handle housing segments 7824, 7826 cooperate to form apistol grip portion 7828 that can be gripped and manipulated by theclinician. As will be discussed in further detail below, the handle 7822operably supports a plurality of drive systems or control systemstherein that are configured to generate and apply various controlmotions to corresponding component portions of the elongated shaftassembly 7850 that is operably attached to the surgical end effector7900. In the illustrated embodiment, the surgical end effector 7900 isconfigured to cut and fasten tissue, for example.

FIG. 65 illustrates one form of surgical end effector 7900 that may beemployed. As can be seen in that Figure, the surgical end effector 7900may comprise an elongated channel 7902 that is configured to receive asurgical fastener cartridge 7910 therein. The surgical fastenercartridge 7910 may include a cartridge body 7912 that has a centrallydisposed elongated slot 7914 therein. The cartridge body 7912 mayfurther include rows of fastener pockets 7916 that are located on eachside of the elongated slot 7914 and which are configured to supportcorresponding surgical fasteners 7920 therein. The elongated channel7902 may further operably support a tissue-cutting member or knifeassembly 7950 therein that is configured to axially travel in the slot7914 in the cartridge body 7912 when installed in the elongate channel7902. The knife assembly 7950 may be configured with a tissue cuttingedge 7952 that is centrally disposed between a lower foot 7954 and anupper foot or tab 7956. As will be discussed in further detail below,the knife assembly 7950 is configured to be axially driven within theelongated channel 7902 and the surgical fastener cartridge 7910 inresponse to motions applied thereto by a firing drive system 8100.

As can also be seen in FIG. 65 , the surgical end effector 7900 mayfurther include an anvil assembly 7930 that is movably supported on theelongate channel 7902. The anvil assembly 7930 may be movable relativeto the surgical fastener cartridge 7910, for example, in response toclosing and opening motions transferred thereto from a closure drivesystem 8000. In other arrangements, however, the anvil assembly may befixed and the surgical fastener cartridge may be configured to moverelative to the anvil assembly upon application of closure motionsthereto. In one arrangement, for example, the anvil assembly 7930includes an anvil body portion 7932 that has a fastener forming surface7934 formed on the underside thereof. The fastener forming surface 7934may comprise a series of forming pockets (not shown) that correspond tothe surgical fasteners 7920 supported in the surgical fastener cartridge7910. As the legs of the surgical fasteners 7920 are driven into formingcontact with the corresponding forming pockets in the anvil assembly7930, they are formed into a desired tissue-retaining configuration. Theanvil assembly 7930 may further include an anvil mounting portion 7936that has a pair of trunnions 7938 protruding therefrom that are receivedwithin corresponding arcuate slots 7906 formed in a proximal mountingportion 7904 of the elongated channel 7902. In various arrangements, thesurgical fasteners 7920 are driven out of their respective fastenerpockets 7916 in the surgical fastener cartridge 7910 by correspondingsled assemblies 7960 and 7970 that are movably supported within theelongated channel 7902 and are movable in response to firing motionsapplied thereto by the firing drive system 8100.

Referring now to FIG. 66 , the handle 7822 may further include a frame7830 that operably supports various components of the closure drivesystem 8000 and the firing drive system 8100. In at least one form, theclosure drive system 8000 may include an actuator in the form of aclosure trigger 8002 that is pivotally supported by the frame 7830. Theclosure trigger 8002 may be pivotally supported by frame 7830 such thatwhen the clinician grips the pistol grip portion 7828 of the handle7822, the closure trigger 8002 may be easily pivoted from a starting orunactuated position to an actuated position and more particularly to afully compressed or fully actuated position. The closure trigger 8002may be biased into the unactuated position by spring or other biasingarrangement (not shown). Various details regarding the certain aspectsof the construction and operation of the closure drive system 8000 maybe found in U.S. patent application Ser. No. 13/803,097, filed Mar. 14,2013, and entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRINGDRIVE, now U.S. Pat. No. 9,687,230, the entire disclosure of which isincorporated by reference herein. As discussed in that reference and asshown in FIG. 66 herein, the closure trigger 8002 may be configured tocooperate with a closure release assembly 8020 that is pivotally coupledto the frame 7830. In at least one form, the closure release assembly8020 may comprise a release button assembly 8022 that may be pivoted ina counterclockwise direction by a release spring (not shown). As theclinician depresses the closure trigger 8002 from its unactuatedposition towards the pistol grip portion 7828 of the handle 7822, theclosure release assembly 8020 serves to lock the closure trigger 8002 inthe fully actuated position. When the clinician desires to unlock theclosure trigger 8002 to permit it to be biased to the unactuatedposition, the clinician simply pivots the closure release buttonassembly 8020 to cause it to disengage the closure trigger arrangementand thereby permit the closure trigger 8002 to pivot back to theunactuated position. Other closure trigger locking and releasearrangements may also be employed.

Referring to FIGS. 66 and 67 , the closure drive system 8000 may furthercomprise a proximal closure tube segment 8010 that has a proximal end8012 that is adapted to be rotatably coupled to a closure tubeattachment yoke 8030. The proximal end 8012 of the proximal closure tubesegment 8010 is configured to be received within a cradle 8032 (FIG. 66) in the closure tube attachment yoke 8030 to permit relative rotationrelative thereto. The proximal closure tube segment 8010 may berotatably attached to the closure tube attachment yoke 8030 by aU-shaped connector 8036 that is configured to be received in an annularslot 8014 in the proximal end 8012 of the proximal closure tube segment8010 and be seated in a slot 8034 (FIG. 66 ) in the closure tubeattachment yoke 8030. Such arrangement serves to rotatably couple theproximal closure tube segment 8010 to the closure tube attachment yoke8030 such that the proximal closure tube segment 8010 may rotaterelative thereto. More specifically, such arrangement facilitates manualrotation of the elongated shaft assembly 7850 relative to the handle7822 about a longitudinal tool axis “LT-LT” defined by the elongatedshaft assembly 7850 to enable the clinician to rotate the surgical endeffector 7900 in the manner represented by arrow “R” in FIG. 64 .

In various arrangements, the closure tube attachment yoke 8030 ismovably mounted on a proximal articulation tube 8202 of an articulationsystem 8200 which will be discussed in further detail below. Sucharrangement permits the closure tube attachment yoke 8030 to moveaxially on the proximal articulation tube 8202 in response to actuationof the closure trigger 8002. In particular, the closure tube attachmentyoke 8030 may be pivotally coupled to the closure trigger 8002 by aclosure linkage bar 8040. See FIG. 66 . Thus, when the clinician pivotsthe closure trigger 8002 inward toward the pistol grip portion 7828 ofthe handle 7822, the closure tube attachment yoke 8030 will be advancedin the distal direction “DD”. When the firing trigger 8002 is returnedto the unactuated position, the closure tube attachment yoke 8030 willbe advanced proximally (direction “PD”) on the proximal articulationtube 8202 to a starting position.

The closure drive system 8000 may further include an intermediateflexible tube segment 8050 that is configured for attachment to thedistal end 8018 of the proximal closure tube segment 8010. As can beseen in FIG. 68 , the intermediate tube segment 8050 may include aflexible articulation portion 8060 and an attachment stem portion 8052.The attachment stem portion 8052 may be sized to extend into the opendistal end 8018 of the proximal closure tube segment 8010 in frictionalengagement therewith. The flexible articulation portion 8060 may beintegrally formed with the attachment stem portion 8052 and include anarticulation spine 8062 that includes proximal end portions 8064 (onlyone can be seen in FIG. 5 ) that are configured to be received incorresponding notches 8019 in the distal end 8018 of the proximalclosure tube segment 8010 to prevent relative rotation between theproximal closure tube segment 8010 and the intermediate tube segment8050. The intermediate tube segment 8050 may be non-rotatably (i.e.,attached to prevent relative rotation between these components) attachedto the proximal closure tube segment 8010 by, for example, screws,detents, adhesive, etc.

The closure drive system 8000 may further include a distal closure tubesegment 8080 that is configured to axially engage and apply opening andclosing motions to the anvil assembly 7930. The distal closure tubesegment 8080 may be attached to the distal end of intermediate tubesegment 8050 for axial travel therewith. The articulation spine 8062 mayfurther include distal end portions 8066 that are configured to bereceived in corresponding notches 8084 in the proximal end 8082 of thedistal closure tube segment 8080 to prevent relative rotation betweenthe distal closure tube segment 8080 and the intermediate tube segment8050. See FIG. 68 . The proximal end 8082 of the distal closure tubesegment 8080 may inwardly extending attachment tabs 8086 that areadapted to be bent into corresponding notches 8067 in the intermediatetube segment 8050. See FIG. 68 . Such arrangement serves to facilitateattachment of the distal closure tube segment 8080 to the intermediatetube segment 8050 for axial travel therewith.

The distal closure tube segment 8080 is configured to apply opening andclosing motions to the anvil assembly 7930. As can be seen in FIG. 70 ,one form of the anvil mounting portion 7936 may be formed with a groove7940 that defines an anvil tab 7942. As can be seen in FIGS. 69 and 71 ,the distal end 8088 of the distal closure tube segment 8080 has aninwardly extending actuation tab 8090 formed therein that is configuredto interact with the anvil tab 7942. For example, when the distalclosure tube segment 8080 is in the open position (FIGS. 69 and 71 ),the actuation tab 8090 is in biasing contact with the anvil tab 7942which serves to pivot the anvil assembly 7930 to the open position. Asshown in FIG. 72 , when the anvil assembly 7930 is in an open position,the trunnions 7938 are located in the bottom of the trunnion slots 7906in the proximal mounting portion 7904 of the elongated channel 7902.When the distal closure tube segment 8080 is advanced distally, thedistal end 8088 contacts an upstanding end wall 7944 on the anvil body7932 to cause the anvil assembly 7930 to pivot or otherwise move towardthe surgical fastener cartridge 7910. When assembled, the trunnions 7938each extend into a corresponding opening 8092 in the distal closure tubesegment 8080. See FIG. 69 .

Operation of the closure drive system 8000 will now be described. Theanvil assembly 7930 may be moved relative to the surgical fastenercartridge 7910 by pivoting the closure trigger toward and away from thepistol grip portion 7828 of the handle 7822. Thus, actuating the closuretrigger 8002 causes the proximal closure tube segment 8010, theintermediate tube segment 8050 and the distal closure tube segment 8080to move axially in the distal direction “DD” to contact the end wall7944 of the anvil body portion 7932 to pivot or otherwise move the anvil7930 toward the surgical fastener cartridge 7910. The clinician maygrasp and manipulate tissue between the anvil assembly 7930 and thefastener cartridge 7910 by opening and closing the anvil assembly 7930.Once the target tissue is captured between the anvil assembly 7930 andfastener cartridge 7910, the clinician may pivot the closure trigger8002 to the fully actuated position wherein it is locked in place forfiring.

As indicated above, the frame 7830 may also be configured to operablysupport the firing drive system 8100 that is configured to apply firingmotions to corresponding portions of the elongated shaft assembly 7850and ultimately to the knife assembly 7950 and the sled assemblies 7960,7970. As can be seen in FIGS. 64 and 73 , the firing drive system 8100may employ an electric motor 8102 that is supported in the pistol gripportion 7828 of the handle 7022. In various forms, the motor 8102 may bea DC brushed driving motor having a maximum rotation of, approximately,25,000 RPM, for example. In other arrangements, the motor 10302 mayinclude a brushless motor, a cordless motor, a synchronous motor, astepper motor, or any other suitable electric motor. A battery 8104 (or“power source” or “power pack”), such as a Li ion battery, for example,may be coupled to the handle 10022 to supply power to a control circuitboard assembly 8106 and ultimately to the motor 8102. FIG. 66illustrates a battery pack housing 8105 that is configured to bereleasably mounted to the handle 7822 for supplying control power to thesurgical instrument 7810. A number of battery cells connected in seriesmay be used as the power source to power the motor 8102. In addition,the power source may be replaceable and/or rechargeable.

As outlined above with respect to other various forms, the electricmotor 8102 can include a rotatable shaft 8108 that operably interfaceswith a gear reducer assembly 8110 that is mounted in meshing engagementwith a with a set, or rack, of drive teeth 8122 on alongitudinally-movable drive member 8120. The gear reducer assembly 8110can include, among other things, a housing 8112 and an output piniongear 8114. See FIG. 10 . In certain embodiments, the output pinion gear8114 can be directly operably engaged with the longitudinally-movabledrive member 8120 or, alternatively, operably engaged with the drivemember 8120 via one or more intermediate gears 8116. The intermediategear, in at least one such embodiment, can be meshingly engaged with theset, or rack, of drive teeth 8122 defined in the drive member 8120. Inuse, the electric motor 8102 can move the drive member distally,indicated by an arrow “DD”, and/or proximally, indicated by an arrow“PD”, depending on the direction in which the electric motor 8102rotates the intermediate gear. In use, a voltage polarity provided bythe battery can operate the electric motor 8102 in a clockwise directionwherein the voltage polarity applied to the electric motor by thebattery can be reversed in order to operate the electric motor 8102 in acounter-clockwise direction. When the electric motor 8102 is rotated inone direction, the drive member 8120 will be axially driven in thedistal direction “DD”. When the motor 8102 is driven in the oppositerotary direction, the drive member 8120 will be axially driven in aproximal direction “PD”. The handle 7822 can include a switch which canbe configured to reverse the polarity applied to the electric motor 8102by the battery. The handle 7822 can also include a sensor that isconfigured to detect the position of the movable drive member 8120and/or the direction in which the movable drive member 8120 is beingmoved.

Actuation of the motor 8102 can be controlled by a firing trigger 8130that is pivotally supported on the handle 7822. The firing trigger 8130may be pivoted between an unactuated position and an actuated position.The firing trigger 8130 may be biased into the unactuated position by aspring (not shown) or other biasing arrangement such that when theclinician releases the firing trigger 8130, it may be pivoted orotherwise returned to the unactuated position by the spring or biasingarrangement. In at least one form, the firing trigger 8130 can bepositioned “outboard” of the closure trigger 8002 as discussed infurther detail in U.S. patent application Ser. No. 13/803,097, now U.S.Pat. No. 9,687,230, which has been previously incorporated by referencein its entirety herein. In at least one form, a firing trigger safetybutton 8132 may be pivotally mounted to the closure trigger 8002. Thesafety button 8132 may be positioned between the firing trigger 8130 andthe closure trigger 8002 and have a pivot arm (not shown) protrudingtherefrom. When the closure trigger 8002 is in the unactuated position,the safety button 8132 is contained in the handle housing where theclinician cannot readily access it and move it between a safety positionpreventing actuation of the firing trigger 8130 and a firing positionwherein the firing trigger 8130 may be fired. As the clinician depressesthe closure trigger 8002, the safety button 8132 and the firing trigger8130 pivot down to a position wherein they can then be manipulated bythe clinician.

As indicated above, in at least one form, the longitudinally movabledrive member 8120 has a rack of teeth 8122 formed thereon for meshingengagement with a corresponding drive gear of the gear reducer assembly8110. At least one form may also include a manually-actuatable “bailout”assembly that is configured to enable the clinician to manually retractthe longitudinally movable drive member 8120 should the motor becomedisabled. U.S. patent application Ser. No. 13/803,097, now U.S. Pat. No.9,687,230, contains further details of one form of bailout assembly thatmay be employed. U.S. Patent Application Publication No. 2010/0089970,now U.S. Pat. No. 8,608,045, also discloses “bailout” arrangements andother components, arrangements and systems that may also be employedwith the various instruments disclosed herein. U.S. patent applicationSer. No. 12/249,117, entitled POWERED SURGICAL CUTTING AND STAPLINGAPPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, and filed on Oct. 10,2008, now U.S. Pat. No. 8,608,045, is incorporated by reference in itsentirety herein.

Referring to FIGS. 67 and 68 , various forms of the elongated shaftassembly 7850 may include a firing member assembly 7860 that issupported for axial travel within an articulation shaft assembly 8230that is part of the articulation system 8200 and which essentiallyfunctions as shaft frame or spine. The firing member assembly 7860 mayfurther include a proximal firing shaft 7862 that has a proximal endportion 7864 that is configured to be rotatably received in a distalcradle 8126 provided in a distal end 8124 of the movable drive member8120. Such arrangement permits the proximal firing shaft 7862 to rotaterelative to the movable drive member 8120 while also axially movingtherewith. The proximal firing shaft 7862 may further have a slot 7868formed in its distal end 7866 for receiving a proximal end 7872 of aflexible distal firing shaft assembly 7870 therein. See FIG. 68 . As canbe seen in that Figure, the proximal end 7872 of the distal firing shaftassembly 7870 may be received within the slot 7868 in the distal firingshaft 7862 and may be pinned thereto with a pin 7873.

The distal firing shaft assembly 7870 may include a central firing beam7874 that is located between a right sled pusher beam 7876 and a leftsled pusher beam 7878. The central firing beam 7874 and the pusher beams7876, 7878 may, for example, each be fabricated from metal thatfacilitates axial actuation of the sled assemblies 7960, 7970 in thesurgical end effector 7900 while also facilitating flexing thereof whenthe end effector 7900 is articulated as will be discussed in furtherdetail below. In at least one arrangement, the central pusher beam 7874,the right sled pusher beam 7876 and the left sled pusher beam 7878 mayextend through a slot 7946 in the anvil mounting portion 7936. The rightsled pusher beam 7876 corresponds to the right sled assembly 7960 andthe left sled pusher beam 7878 corresponds to the left sled assembly7970 movably supported within the elongated channel 7902. Axial movementof the right sled pusher beam 7876 and the left sled pusher beam 7878will result in the axial advancement of the right and left sledassemblies 7960, 7970, respectively, within the elongated channel 7902.As the right sled assembly 7960 is axially advanced within the elongatedchannel 7902, it drives the surgical fasteners 7920 supported in thecartridge body 7912 on the right side of the slot 7914 out of theirrespective pockets 7916 and as the left sled assembly 7970 is axiallyadvanced within the elongated channel 7902, it drives the surgicalfasteners 7920 supported within the cartridge body 7912 on the left sideof the slot 7914 out of their respective pockets 7916.

The central firing beam 7874 has a distal end 7880 that may beconfigured to be received within a slot 7951 provided in the knifeassembly 7950 and retained therein by, for example, a frictional fit,adhesive, welding, etc. A bottom window 7905 may be formed in a distalend 7903 of the elongated channel 7902 to enable the knife assembly 7950to be inserted therethrough. In at least one form, the elongated channel7902 is formed with a right upstanding wall 7907 and a left upstandingwall 7908 that define a centrally-disposed channel slot 7909. Once theknife assembly 7950 is inserted into the bottom window 7905 in theelongated channel 7902, the body portion of the knife assembly 7950 maybe inserted into the channel slot 7909 and advanced proximally in theelongated channel 7902 to be coupled with the distal end 7980 of thecentral firing beam 7874. A lower channel cover 7911 may be attached tothe bottom of the elongated channel 7902 to prevent tissue, body fluids,etc. from entering into the elongated channel 7902 which might hamperthe movement of the knife assembly 7950 therein.

In one form, the anvil assembly 7930 may be installed onto the elongatechannel 7902 as follows. To commence the installation process, the anvilassembly 7930 is positioned over the elongated channel 7902 such thatthe trunnions 7938 may be inserted into notches 7913 in the proximalmounting portion 7904 of the elongated channel 7902 which enable thetrunnions 7938 to enter the corresponding trunnion slots 7906 in theelongated channel 7902. See FIG. 65 . This installation may be performedbefore the distal closure tube segment 8080 has been attached to theintermediate tube segment 8050 or after the distal closure tube segment8080 has been moved sufficiently proximally to permit the anvil to be sopositioned. Once the trunnions 8038 are received within their respectivetrunnion slots 7906, the distal closure tube segment 8080 may be movedto the position shown in FIGS. 71 and 72 wherein the distal closure tubesegment 8080 retains the trunnions 7938 in their respective trunnionslots 7906 and the actuation tab 8090 is in biasing contact with theanvil tab 7942 which serves to pivot the anvil assembly 7930 to the openposition. When in that position, each trunnion 7938 protrudes into acorresponding opening 8092 in the distal closure tube segment 8080. SeeFIG. 69 . As shown in FIGS. 65 and 71 , when the anvil assembly 7930 isin an open position, the upper end of the knife assembly 7950 enters awindow 7933 in the anvil body portion 7932. Such window 7933 providesclearance for the anvil assembly 7930 to be moved to the closedpositions while the knife assembly 7950 remains in the unactuatedposition. Once the anvil assembly 7930 has been installed with the knifeassembly 7950 in place, an anvil cover 7935 may be attached to the anvilbody 7934 to prevent tissue, body fluids, etc. from entering into theanvil body 7934 which might hamper the movement of the knife assembly7950 therein. As the knife assembly 7950 is advanced distally in the endeffector 7900, the upper tab 7956 of the knife assembly 7950 engagesledges in the anvil body and the lower foot 7954 engages portions 7915of the elongated channel 7902 and serves to retain the anvil assembly7930 in the closed position and essentially maintain the spacing betweenthe anvil assembly 7930 and the fastener cartridge 7910.

FIGS. 70A and 70B illustrate an alternative distal closure tubearrangement 8080′ that may work with an anvil assembly 7930′ that may besubstantially identical to anvil assembly 7930 except that anvilassembly 7930′ lacks an anvil tab. In such an arrangement, for example,each trunnion 7938 extends into a corresponding opening 8092′ in thedistal closure tube segment 8080′. The distal closure tube segment 8080′further includes an inwardly extending gill tab 8094 that protrudesinward for contact with the corresponding anvil trunnion 7938. When thedistal closure tube segment 8080′ is drawn in the proximal direction“PD”, each gill tab 8094 contacts the corresponding trunnion 7938 tocause the trunnion to move downwardly in its corresponding trunnion slot7906 in the elongated channel 7902 to pivot or otherwise move the anvilassembly 7930′ into open positions. FIG. 70C illustrates yet anotherdistal closure tube arrangement 8080″ wherein the actuation tab isformed by an indentation 8090″ in the distal closure tube segment 8080″for interaction with the anvil tab 7942 in the above-described manner.

FIG. 70D illustrates an alternative anvil assembly 7930″ wherein theanvil tab 7942′ is removably attached to the anvil mounting portion7936. In one arrangement for example, the anvil tab 7942′ is configuredwith a snap tab 7943 arranged to retainingly engage an opening 7941 inthe anvil mounting portion 7936. The anvil assembly 7930″ may otherwisebe the same as anvil assembly 7930 described above and be opened andclosed in similar manners by the distal closure tube segment 8080. FIG.70E illustrates yet another anvil assembly 7930″ wherein the anvil tabis formed by a screw 7948 that is removably attachable to the anvilmounting portion 7936. Such removable anvil tab/screw arrangements mayfacilitate ease of installation of the anvil assembly 7930″.

Referring to FIGS. 67 and 68 , one form of articulation system 8200includes an articulation shaft assembly 8230 that may be operablycontrolled by an articulation control system 8260. In one form, forexample, the articulation shaft assembly 8230 may include a rightarticulation shaft segment 8240 and a left articulation shaft segment8250. The right articulation shaft segment 8240 includes a proximal end8242 that has a right passage segment 8244 formed therein. Likewise theleft articulation shaft segment 8250 includes a proximal end portion8252 that has a left passage segment 8254 formed therein. When the rightarticulation shaft segment 8240 and the left articulation shaft segment8250 are installed within the proximal closure tube segment 8010, theyform the articulation shaft assembly 8230. The right passage segment8244 and the left passage segment 8254 cooperate to receive a portion ofthe proximal firing shaft 7862 therein. The right articulation shaftsegment 8240 and the left articulation shaft segment 8250 may be, forexample, composed of a plastic, especially a glass fiber-reinforcedamorphous polyamide, sold commercially under the trade name GrivoryGV-6H by EMS-American Grilon.

In various arrangements, for example, the articulation control system8260 may include a nozzle assembly 8262 that is supported for rotationaltravel relative to the handle 7822. As can be seen in FIG. 67 , thenozzle assembly 8262 may comprise an upper nozzle segment 8264 and alower nozzle segment 8266 that are attached together by a series offasteners (e.g., screws) 8268. The upper nozzle segment 8264 may beconfigured to rotatably support an articulation control knob 8270thereon. In one arrangement, for example, the articulation control knob8270 extends through an opening (not shown) in the upper nozzle segment8264 and is coupled to an articulation gear member 8272 by screws 8274.The articulation gear member 8272 may include articulation spur gear8276 that extends into an opening 8016 in the proximal end portion 8012of the proximal closure tube segment 8010. As can be further seen inFIG. 67 , the articulation system 8200 further includes a rightactuation tube adapter 8278 and a left articulation tube adapter 8280.The right articulation tube adapter 8278 has a right recess 8279 formedtherein that is adapted to receive a right adapter lug 8246 formed onthe proximal end 8242 of the right articulation shaft segment 8240.Likewise, the left articulation tube adapter 8280 includes a left recess8282 that is adapted to engage a left adapter lug 8256 formed on theproximal end 8252 of the left articulation shaft segment 8250. The rightarticulation tube adapter 8278 further has a series of rightarticulation drive gears 8281 that are configured for meshing engagementwith the articulation spur gear 8276. The left articulation tube adapter8280 has a series of left articulation drive gears 8284 formed thereinthat are adapted to intermesh with the articulation spur gear 8276.Thus, when the articulation control knob 8270 is rotated about a controlaxis CA-CA that is transverse to the longitudinal tool axis LT-LTrelative to the handle 7822 (FIG. 64 ), the left articulation shaftsegment 8250 is, for example, driven axially in the distal direction“DD” within the proximal closure tube segment 8010 and the rightarticulation shaft segment 8240 is simultaneously axially driven in theproximal direction “PD”.

Still referring to FIG. 68 , the articulation shaft assembly 8230 mayfurther include a right articulation band 8290 and a left articulationband 8300. In one form, a proximal end portion 8292 of the rightarticulation band 8290 may be attached to a distal portion 8248 of theright articulation shaft segment such that a distal portion 8294 of theright articulation band 8290 protrudes out of a right passage 8249therein. The proximal end portion 8292 of the right articulation band8290 may include holes or cavities 8293 that are configured to receivecorresponding lugs (not shown) in the right articulation shaft segment8240 to facilitate attachment of the right articulation band 8290 to theright articulation shaft segment 8240. Likewise, a proximal end portion8302 of the left articulation band 8300 may have holes or cavities 8303therein that are configured to receive lugs (not shown) in the distalportion 8258 of the left articulation shaft segment 8250 to facilitateattachment of the left articulation band 8300 to the articulation shaftsegment 8250. The articulation bands 8290 and 8300 may be composed of ametal, advantageously full hard 301 stainless steel or its equivalent.

Referring now to FIGS. 75-78 , as was briefly discussed above, theintermediate tube segment 8050 may have an attachment stem portion 8052and a flexible articulation portion 8060. In various arrangements, theintermediate tube segment 8050 may be fabricated from, for example,rigid thermoplastic polyurethane sold commercially as ISOPLAST grade2510 by the Dow Chemical Company and include a centrally disposed,vertically-extending articulation spine 8062. The articulation spine8062 includes a proximal spine end 8064 and a distal spine end 8066 thatfacilitate attachment to the proximal closure tube segment 8010 and thedistal closure tube segment 8080, respectively as was discussed above.The articulation spine 8062 further includes a centrally disposedcomponent or knife slot 8070 for facilitating the passage of variouscontrol components therethrough. In the illustrated arrangement, theslot 8070 movably supports the central firing beam 7874, the rightpusher beam 7876 and the left pusher beam 7878. In various forms, thecentrally disposed slot 8070 is substantially enclosed to retard orprevent infiltration of body fluids and tissue therein which mightotherwise hamper the movement of the control components operably passingtherethrough.

As can be most particularly seen in FIG. 78 , the flexible articulationportion 8060 further includes a plurality of right ribs 8310 and aplurality of left ribs 8320 that may be integrally-formed with, andlaterally protrude from, the articulation spine 8062. In various forms,for example, each right rib 8310 may comprise a rib body portion 8312that is spaced from the articulation spine 8062 by a corresponding rightrib neck portion 8316. Likewise, each left rib 8320 may comprise a leftrib body portion 8322 that is spaced from the articulation spine 8062 bya left rib neck portion 8326. As can be seen in FIG. 76 , the left andright rib body portions 8312, 8322 have an arcuate shape to provide theflexible articulation portion 8060 of the intermediate tube segment 8050with a substantially-circular cross-sectional shape. Such shape mayfacilitate easy passage of the intermediate tube segment 8050 through acircular passage such as, for example, an appropriately sized trocar.

In various arrangements, each of the right rib neck portions 8016 servesto define a right articulation passage 8318 for movably receiving theright articulation band 8290 therethrough. The right articulation band8290 may extend through the right articulation passage 8318 and becoupled to the proximal mounting portion 7904 of the elongate channel7902. For example, the distal end 8294 of the right articulation band8290 may have a right hook portion 8296 that is adapted to be coupled toa right attachment portion 8297 of the elongated channel 7902. See FIG.65 . Similarly, each of the left rib neck portions 8326 serves to definea left articulation passage 8328 for movably receiving the leftarticulation band 8300 therethrough. The left articulation band 8300 mayextend through the left articulation passage 8328 and be coupled to theproximal mounting portion 7904 of the elongated channel 7902. Forexample, the distal end 8304 of the left articulation band 8300 may havea left hook portion 8306 that is adapted to be coupled to a leftattachment portion 8307 of the elongated channel 7902.

One method of operating the articulation system 8200 will now bedescribed. When the clinician wishes to articulate the end effector 7900to the right relative to the longitudinal tool axis LT-LT (the rightdirection is represented by arrow “RD” in FIG. 78 ), the cliniciansimply rotates the articulation control knob 8270 in the appropriatedirection. For example, turning the control knob 8270 in a clockwisedirection (when viewed from above) causes the left articulation band tobe pushed in the distal direction “DD” and the right articulation band8290 is drawn in the proximal direction “PD” which serve to apply anarticulation motion to the elongated channel 102. As the articulationmotion is applied to the elongated channel 7902, the flexiblearticulation portion 8060 flexes to accommodate the movement of thesurgical end effector 7900 in the “right” direction. Conversely, if theclinician wishes to articulate the end effector 7900 in the leftdirection “LD”, the clinician simply rotates the control knob 8270 in acounterclockwise direction which causes the right articulation band 8290to be pushed in the distal direction “DD” and the left articulation band8300 to be drawn in the proximal “PD” direction thereby causing thesurgical end effector 7900 to move to the left. The end effector 7900may also be articulated by a robotic system (not shown) that isconfigured to apply control motions to the articulation bands 8290,8300.

Upon application of the above-described articulation motions to thesurgical end effector 7900, it may be desirable to avoid twisting ortorquing the flexible articulation portion 8060 of the intermediate tubesegment 8050. If such torque or twisting were to occur, the possibilityexists for hampering or, in instances of severe twisting, completelyjamming the operation of the central firing beam 7874 and the right andleft sled pusher beams 7876, 7878. To avoid this problem, the right andleft ribs 8310, 8320 may be uniquely configured to prevent twistingbetween the ribs.

In at least one arrangement, for example, each rib body 8312 has lateralends that are arranged in spaced, confronting relationship with thelateral ends of the rib bodies of adjacent ribs. Referring again to FIG.78 , for example, the rib body 8312 of each right rib 8310 has a firstright lateral end 8313 and a second right lateral end 8314. With theexception of the proximal-most right rib 8310P and the distal-most rightrib 8310D, the first right lateral end 8313 of one right rib 8310 is inconfronting relationship with the second right lateral end 8314 of anadjacent right rib 8310. When the flexible articulation portion 8060 ofthe intermediate tube segment 8050 is unarticulated (e.g., the flexiblearticulation portion 8060 is substantially axially aligned on thelongitudinal tool axis LT-LT), the first right lateral end 8313 of eachright ribs 8310 is spaced from the second right lateral end 8314 of theadjacent right rib 8310 by a right rib space 8315. In the arrangementdepicted in FIG. 78 , for example, all of the right rib spaces 8315 havesubstantially the same space width “SWR”. Likewise, the rib body 8322 ofeach left rib 8320 has a first left lateral end 8323 and a second leftlateral end 8324. With the exception of the proximal-most left rib 8320Pand the distal most left rib 8320D, the first left lateral end 8323 ofone left rib 8320 is in confronting relationship with the second leftlateral end 8324 of an adjacent left rib 8320. When the flexiblearticulation portion 8060 of the intermediate tube segment 8050 isunarticulated, the first left lateral end 8323 of each left rib 8320 isspaced from the second left lateral end 8324 of the adjacent left rib8320 by a left rib space 8325. In the arrangement depicted in FIG. 78 ,for example, all of the left rib spaces 8325 have substantially the samespace width “SWL”. In at least one form, the right rib space widths SWRare substantially the same as the left rib space widths SWL. However,the right and left rib space widths may differ from each other.

Still referring to FIG. 78 , each rib may be provided with atwist-preventing configuration, generally designated as 8330. In atleast one arrangement, for example, an anti-twist protrusion 8332 may beformed on each of the first right lateral ends 8313 of the right ribbodies 8312 and on each of the first left lateral ends 8323 of each ofthe left rib bodies 8322. Each anti-twist protrusion 8332 correspondswith a substantially complementary-shaped recces 8334 formed in the ribthat is immediately adjacent and in confronting relationship therewith.FIG. 77 illustrates this arrangement on the left ribs 8320. In at leastone arrangement, the right ribs 8310 employ an identical configuration.In at least one form, the protrusions 8332 may be substantially alignedalong a lateral axis. That is, the protrusions 8332 formed on the rightribs 8310 may be substantially aligned along a right lateral axisRLA-RLA on the right side of the articulation spine 8062 and theprotrusions 8332 formed on the left ribs 8320 may be substantiallyaligned on the left side of the articulation spine 8062 along a leftlateral axis LLA-LLA. When the flexible portion 8060 is unarticulated,the right lateral axis RLA-RLA, the left lateral axis LLA-LLA and thelongitudinal tool axis LT-LT may be substantially parallel to eachother. As can be seen in FIG. 78 , the right lateral axis RLA-RLA andthe left lateral axis LLA-LLA are spaced from the longitudinal tool axisLT-LT.

As the flexible articulation portion 8060 is articulated in the rightdirection “RD”, at least some of the protrusions 8332 on the right ribs8310 will frictionally engage a portion of a corresponding recess 8332in an adjacent right rib 8310 to prevent the flexible portion 8060 fromtwisting. Similarly, as the flexible articulation portion 8060 isarticulated in the left direction “LD”, at least some of the protrusions8332 on the left ribs 8320 will engage a portion of the recess 8332 inan adjacent left rib 8320 in a “twist-preventing orientation” to preventthe flexible portion 8060 from twisting. This engagement/orientationbetween the protrusion 8332 and the bottom of the cavity 8334 in anadjacent left rib 8320, for example, is illustrated in FIG. 79 . As canbe seen in that Figure, in that example, the first left lateral end 8323of one of the second rib 8320 is in abutting contact with the secondleft lateral end 8324 of an adjacent left rib 8320 to thereby prevent orretard twisting of the flexible portion 8060 of the intermediate tubesegment 8050.

Various alternative anti-twist arrangements are also contemplated. Forexample, the anti-twist features may not be provided on, for example,the proximal-most four ribs. In still other arrangements, the anti-twistfeatures may be provided in a plurality of ribs comprising a centralarea of the flexible segment, but not in the proximal-most and distalmost ribs. In, other arrangements, the anti-twist features may beemployed on every other pair of ribs along the length of the flexiblesegment. For example, the proximal-most pair of adjacent ribs may haveanti-twist features, then the next rib or ribs (distal to those ribs)may not have anti-twist features and the next ribs (distal thereto) mayhave the anti-twist features and so on. These alternative arrangementsmay be applied only to the ribs on one side of the articulation spine orthey may be employed on the ribs on both sides of the articulationspine. By altering the number, location and/or spacing of the ribs withthe anti-twist features, as well as the space widths between the ribs(with and without anti-twist features), as well as the geometric shapeof the articulation spine, one can advantageously adjust the overallflexibility of the flexible segment, its degree of articulation, itsdegree of stiffness and its rate of articulation.

Referring to FIGS. 75 and 76 , in the illustrated arrangement, thearticulation spine 8062 is elongated and has a height, generallydesignated as “H”. In at least one arrangement, the height “H” issubstantially consistent for the length “L” of the articulation spine8062. In addition, the articulation spine 8062 may decreasingly taperfrom the proximal end portion 8064 to the distal end portion 8066. Morespecifically, as can be seen in FIG. 75 , the proximal end portion 8064has a proximal width “PW” and the distal end portion 266 has a distalwidth “DW”. In the illustrated embodiment, the “PW” is greater than thedistal width “DW” and the width of the articulation spine 8062 graduallytapers in width (as opposed to height) from the proximal end 8064 to thedistal end 8066 along length “L”. Such tapered articulation spinearrangement further serves to retard twisting during articulation of thesurgical end effector while facilitating increased articulation of thedistal end of the flexible portion 8060 relative to the proximal end ofthe flexible portion 8060 and while facilitating movable passage ofvarious control components (e.g., central firing beam 7874, right sledpusher beam 7876, left sled pusher beam 7878, etc.) therethrough.

Further, in one arrangement, when the flexible portion 8060 is in anunarticulated or flexed position, all of the right rib spaces 8315 andleft rib spaces 8325 have the same starting width. Thus, in thatconfiguration, SWR=SWL. FIGS. 80 and 81 illustrate another intermediatetube segment 8050′ that may be substantially identical to theintermediate tube segment 8050 described above, except that the rightrib spaces 8315 and the left rib spaces 8325 decrease in magnitude goingfrom the proximal end of the flexible articulation portion 8060′ to thedistal end of the flexible articulation portion 8060′. That is, theproximal-most right rib space 8315P′ is the widest right rib space andthe distal most right rib space 8315D′ is the narrowest right rib spacewith the right rib spaces 8315′ getting successively narrower going inthe distal direction “DD”. Similarly, the proximal-most left rib space8325P′ is the widest left rib space and the distal-most left rib space8325D′ is the narrowest left rib space with the left rib spaces 8325′getting successively narrower going in the distal direction. In sucharrangement, when the articulation motion is applied to the surgical endeffector, the flexible portion 8060 will have a faster rate of flexureat its distal end. That is, a distal portion of flexible segment 8060′will flex or articulate at a rate that is greater than a rate at whichanother portion of 8060′ that is proximal to that distal segment willarticulate upon application of an articulation motion to the endeffector. Stated another way, relative movement between the ribs on thedistal end will stop before the relative movement between the moreproximal ribs stops because the spaces between the distal ribs aresmaller than the spaces between the proximal ribs. In the illustratedarrangement the widths of the right and left rib spaces 8315′ and 8325′that are laterally aligned with each other may be equal in magnitude.Such rib space width arrangements may enable the flexible articulationportion 8060′ to assume a substantial “U”-shape if desired. See e.g.,FIG. 82 . It will be understood, however, that various other slot widtharrangements, sizes and configurations may be employed to achieve adesired amount/range of articulation while preventing the intermediatetube from inadvertently twisting about the longitudinal tool axis.

FIG. 83 depicts another surgical instrument 8410 that is capable ofpracticing several unique benefits of the present invention. Thesurgical instrument 8410 is designed to manipulate and/or actuatevarious forms and sizes of end effectors 8412 that are operably attachedto an elongated shaft assembly 8500 of the surgical instrument. In thedepicted embodiment, for example, the end effector 8412 comprises asurgical stapling device that has openable and closable jaws 8413 and8415. More specifically, the end effector 8412 includes an elongatedchannel 8414 that forms a lower jaw 8413 of the end effector 8412. SeeFIG. 84 . In the illustrated arrangement, the elongated channel 8414 isconfigured to operably support a staple cartridge 8430 and also movablysupports an anvil 8420 that functions as an upper jaw 8415 of the endeffector 8412.

Referring now to FIGS. 84 and 85 , the anvil 8420 may have a mountingportion 8422 that protrudes from its proximal end 8421. The mountingportion 8422 may have lateral mounting holes 8424 therethrough thatenable the mounting portion 8422 to be pivotally pinned to an upstandingpivot boss 8417 formed in the elongated channel 8414 by an anvil pin8418. The anvil 8420 may be selectively “moved” towards the surgicalstaple cartridge 8430 mounted in the elongated channel 8414 by axiallyadvancing a distal closure tub segment 8590 in the distal direction “DD”as will be discussed in further detail below. In variousimplementations, for example, a first anvil actuation member in the formof an anvil camming pin 8419 may extend through a camming slot 8423provided in the anvil mounting portion 8422. The camming pin 8419 ismounted in holes 8591 provided in the distal closure tube segment 8590such that movement of the distal closure tube segment 8590 in the distaland proximal directions will result in the movement of the camming pin8419 in the camming slot 8423. In addition, the distal closure tubesegment 8590 may further include a second anvil actuation member in theform of, for example, an actuation pin 8593 that is positioned tointeract with an angled actuation surface 8425 formed on the proximalend of the anvil mounting portion 8522. FIGS. 89-91 illustrate the anvil8420 in a first or open position. The anvil 8420 may be moved to aclosed position by moving the distal closure tube segment 8590 in thedistal direction “DD”. Movement of the distal closure tube segment 18590in the distal direction “DD” causes the first camming pin 8419 to movewithin the camming slot 8423 in the anvil mounting portion 8422 whichthereby causes the anvil 8420 to pivot about the anvil pin 8418 to theclosed position as illustrated in FIGS. 86-88 . To return the anvil10020 to the open position (FIGS. 89-91 ), the distal closure tubesegment 8590 is moved in the proximal direction “PD” which causes thefirst camming pin 8419 to move in the camming slot 8423 in an oppositedirection and cam the anvil 8420 to the open position. Such closure tubearrangement differs from prior closure tube arrangements wherein thedistal end of the closure tube segment is configured to contact theanvil and pivot it to a closed position. Use of the present camming pinarrangements does not require use of an anvil that has a more robustportion configured for actuation contact with the closure tube segment.

In various arrangements, the end effector 8412 may be configured to beselectively articulated about a longitudinal tool axis LT-LT that isdefined by the elongated shaft assembly 8500. For example, the elongatedshaft assembly 8500 may include a flexible neck assembly 8510 thatenables the end effector 8412 to articulate in a first direction “FD”that is essentially the same direction that the anvil 8420 moves in whenthe anvil 8420 is moved from an open position to a closed position(hereinafter referred to as the anvil closing direction “CD”). See FIGS.86 and 90 . The flexible neck assembly 8510 will further facilitatearticulation of the end effector 8412 in a second articulation direction“SD” that is essentially the same as the direction that the anvil movesfrom a closed position to an open position (hereinafter referred to theanvil opening direction “OD”). See FIGS. 86, 89 and 90 .

Various flexible neck assemblies are disclosed in U.S. ProvisionalPatent Application Ser. No. 61/386,117, entitled ARTICULATING SURGICALDEVICE, and filed Sep. 24, 2010, the entire disclosure of which isherein incorporated by reference. Other flexible neck assemblies aredisclosed in U.S. Patent Application Publication No. 2012/0074200,entitled SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE ENDEFFECTOR, and filed Sep. 23, 2011, the entire disclosure of which ishereby incorporated by reference herein. The flexible neck assembly 110may, for example, be composed of rigid thermoplastic polyurethane soldcommercially as ISOPLAST grade 2510 by the Dow Chemical Company. Theflexible neck assembly 8510 may have a flexible neck segment 8511 thatcomprises a first or upper flexible neck portion 8512 and a second orlower flexible neck portion 8514. These neck portions 8512, 8514 may beseparated by a longitudinal rib portion 8516. The neck portions 8512,8514 may each have a plurality of neck ribs 8518 that are configuredessentially as semi-circular disks which together generally form acylindrical configuration. An upper slot 8520 extends through each ofthe neck ribs 8518 of the first or upper flexible neck portion 8512 toform a passage through the first flexible neck portion 8512 forreceiving a first flexible transmission band assembly 8550 therethrough.Similarly, a lower slot 8521 extends through each of the neck ribs 8518in the second or lower flexible neck portion 8514 to form a passage forreceiving a second flexible transmission band assembly 8570therethrough. See, for example, FIG. 86 . The flexible neck assembly8510 may include guide surfaces 8524 (only one can be seen in FIG. 92 )that extend proximally from the flexible neck segment 8511 forsupporting the reciprocating movement of the flexible transmission bandassemblies 8550, 8570.

As can be seen in FIG. 92 , the first or upper transmission bandassembly 8550 may include a first transmission band 8552 and the secondtransmission band assembly 8570 may include a second transmission band8572. In addition, the first transmission band 8550 may have a firstelongated structural portion 8554 and the second transmission band 8570may have a second elongated structural portion 8574. When the first andsecond transmission bands 8550, 8570 are brought into contact with eachother during assembly of the instrument, they form an elongated cylinderwhich has a longitudinal cavity 8560 extending concentrically through itto operably receive a firing rod 10530 therethrough. See FIGS. 93 and 94. The first structural portion 8554 of the first transmission band 8552has a first articulation rack 8556 formed thereon and the secondstructural portion 8574 of the second transmission band 8572 has asecond articulation rack 8576 formed thereon which, as will be discussedin further detail below, drivingly interface with an articulationtransmission assembly 8600.

Referring again to FIG. 92 , the first transmission band 8552 may have afirst exterior reinforcement band portion 8557 that extends distallyfrom the first structural portion 8554. Likewise, the secondtransmission band 8572 may have a second exterior reinforcement bandportion 8577 that extends distally from the second structural portion8576. Each exterior reinforcement band portion 8557, 8577 may have aplurality of attachment lugs 8562 for securing first and second interiorarticulation bands 8558, 8578 thereto. For example, the firsttransmission band 8552 has a first interior articulation band 8558attached thereto and the second transmission band 8572 has a secondinterior articulation band 8578 attached thereto. The first and secondtransmission bands 8552, 8572 may be composed of a plastic, especially aglass fiber-reinforced amorphous polyamide, sold commercially under thetrade name Grivory GV-6H by EMS-American Grilon. In contrast, theinterior articulation bands 8558, 8578 of the transmission band assemblymay be composed of a metal, advantageously full hard 301 stainless steelor its equivalent. The attachment lugs 8562 on the exteriorreinforcement band portions 8557, 8577 of the transmission bands 8552,8572, respectively, are received into and secured within a plurality oflug holes 8564 on the corresponding interior articulation band 8558,8578. See FIG. 92 .

In at least one implementation, the proximal end of the elongatedcartridge channel 8414 is provided with a pair of upper and lower bandconnector ears 8450. See FIGS. 84 and 86-88 . These band connector ears8450 are inserted into and through connector loops 8559, 8579 on thedistal end of the interior articulation bands 8558, 8578, respectively.In this manner, the cartridge channel 8414 is coupled to the interiorarticulation bands 8558, 8578 of the flexible neck assembly 8510.Specifically, the reciprocation of the first and second flexibletransmission band assemblies 8550, 8570 in opposite directions causesthe interior articulation bands 8558, 8578 received in the upper andlower slots 8520, 8521 on the flexible neck segment 8511 to reciprocatein a like manner. Upon reciprocation of the interior articulation bands8558, 8578, in particular when the first band 8558 is moved proximallyin tandem with the second band 8578 moving distally, the first andsecond flexible neck portions 8514, 8516 bend as the neck ribs 8518 ofthe first flexible neck portion 8514 move toward each other and the neckribs 8518 of the second flexible neck rib portion 8516 concurrently moveaway from each other. The coupling of the interior articulation bands8558, 8578 to the exterior reinforcement band portions 8557, 8577 of thetransmission bands 8552, 8572, respectively prevents the interiorarticulation bands 8558, 8578 from buckling between adjacent neck ribs.

In various arrangements, the distal closure tube segment 8590 is slidover the channel guide 8528 of the flexible neck assembly 8510. Theproximal end 8591 of the distal closure tube segment 8590 has a pair ofdiametrically opposed slots 8592 therein (only one can be seen in FIGS.83 and 92 ) for receiving distally protruding lugs 8513 protruding fromthe flexible neck portion 8511 to prevent rotation of the distal closuretube segment 8590 relative to the flexible neck portion 8511. In variousembodiments, the distal closure tube segment 8590 may be retained on thechannel guide 8528 by a retention tab (not shown) that extends into thefastener hole (not shown) in the channel guide 8528. However, otherfastening arrangements may be employed, for example. Such arrangementcauses the distal closure tube segment 8590 to move axially with theflexible neck assembly 8510.

Movement of the first and second transmission bands 8552, 8572 may becontrolled by an articulation transmission assembly 8600. The componentparts of one form of articulation transmission assembly 8600 areillustrated in FIG. 92 . In one form, the articulation transmissionassembly 8600 may include an actuator 8610, an articulation body 8620and a nozzle 8650 (FIGS. 83 and 94 ). Rotational movement of theactuator 8610 causes corresponding rotation of the articulation body8620 within the nozzle 8650. The first and second elongated transmissionbands, 8552 and 8572, consequently reciprocate axially in oppositedirections parallel to the longitudinal tool axis LT-LT of the elongatedshaft assembly 10100 to cause the remote articulation of the endeffector 8412.

Still referring to FIG. 92 , the articulation body 8620 has a deck 8622consisting of first and second spaced-apart, semicircular deck halves,8624, 8626. The deck halves are mutually opposed to each other andessentially represent mirror images of each other. The first and seconddeck halves 8624, 8626 have protruding from their surfaces mutuallyopposed first and second detents 8625, 8627, respectively. Each deckhalf 8624, 8626 has a set of deck teeth 8628 spaced about 180 degreesfrom the set of deck teeth on the other deck half. The articulation body8620 has a pair of rotation stops 8630 protruding from its surface aswell as a pair of finger recesses 8632. A drive gear 8640 protrudeslaterally from the articulation body 8622. The drive gear 8640 has aflared opening 8642 through it, and a lateral pivot 8644. Within theflared opening 8642 of the drive gear 8640, there is a firing rodorifice (not shown) for receiving a firing rod 8930 therethroughenabling the application of a firing motion to the end effector 8412.The drive gear 8640 is configured to intermesh with the first and seconddrive racks 8556, 8576, respectively to effect the desired reciprocatingmovement of the first and second transmission bands 8552, 8572. See FIG.94 .

The nozzle 8650 of the articulation transmission assembly 8600 mayinclude a nozzle body 8652. The nozzle body 8652 may have an axial bore8654 therethrough that facilitates the passage of the first transmissionband assembly 8550 and the second transmission band assembly 8570 aswell as for the firing rod 8930 and other operative components of theinstrument 8410 including a the proximal end 8706 of a proximal outershaft segment 8700. See FIG. 94 . The nozzle body 8652 may also have aframe groove 8656 and flange 8658 to rotatably fasten the nozzle body8652 to a housing 8800. In various forms, a detent housing 8660comprises a portion of the nozzle body 8652. See FIG. 95 . An annulararray of detent teeth (not shown) is formed within the detent housing8660. A detent housing floor is spaced from the detent teeth. The floormay have a pair of ledges which interact within the rotation stops 8630of the articulation body 8620 to limit the degree of rotation. When thearticulation body 8620 is inserted into the detent housing 8660, thebase of the articulation body 8620 is supported on the floor within thedetent housing 8660, and the deck teeth 8628 of the first and seconddeck halves, 8624, 8626 are aligned for meshing engagement with thedetent teeth of the detent housing 8660. A spring member 8668 issupported within the articulation body to bias the deck teeth 8628 intomeshing engagement with the detent teeth.

Referring again to FIG. 92 , the actuator 8610 may consist of a leverarm 8612, a cap 8614 and a pair of retaining fingers 8616. The lever arm8612 is mounted on the top of the cap 8614. The pair of retainingfingers 8616 protrudes laterally from the underside of the cap 8614.Each of the retaining fingers 8616 has a retaining clip. The retainingfingers 8616 are received within the finger recesses 8632 of thearticulation body 8620. First and second detents, 8625, 8627, on thedeck halves of the articulation body are inserted into a slot depressionwithin the underside of the circular cap 8614. Advantageously, each ofthe three significant components of the articulation transmissionassembly, namely the actuator, articulation body and nozzle, may beinjection molded components. Such components, for example, may befabricated from a glass fiber-reinforced amorphous polyamide, soldcommercially under the trade name Grivory GV-4H by EMS—American Grilon150.

Ratcheting rotation of the actuator 8610 causes articulation of the endeffector 8412 in the first or second directions relative to thelongitudinal tool axis LT-LT. FIG. 86 illustrates the end effector 8412in an unarticulated position in solid lines and exemplary ranges ofarticulation in broken lines. When the drive gear 8640 on thearticulation body 8620 of the articulation transmission 8600 is rotatedto thereby drive the first transmission band assembly 8550 distally inthe “DD” direction and the second transmission band assembly 8570proximally in the proximal direction “PD”, the end effector 8412 willarticulate in the first articulation direction “FD” relative to thelongitudinal tool axis LT-LT. When the drive gear 8640 on thearticulation body 8620 of the articulation transmission 8600 has beenrotated to thereby drive the second articulation band assembly 8570 inthe distal direction “DD” and the first articulation band assembly 8550in the proximal direction “PD”, the end effector 8412 will pivot in asecond direction “SD” relative to the longitudinal tool axis LT-LT.

As can be seen in FIG. 93 , the elongated shaft assembly 8500 furtherincludes a proximal outer shaft segment 8700 that is attached to theflexible neck assembly 8510. The proximal outer shaft segment 8700 issubstantially rigid and may be attached to the flexible neck portion8511 of the flexible neck assembly 8510 by, for example, a press fit,adhesive or other suitable fastener arrangement. As can be seen in FIG.94 , in at least one embodiment, the distal end 8702 of the proximalouter shaft segment 8700 has a pair of opposed notches 8704 therein thatare adapted to receive corresponding lugs 8515 protruding from theflexible neck portion 8511 such that rotation of the proximal outershaft segment 8700 results in rotation of the flexible neck assembly8510 and ultimately of the end effector 8412.

Still referring to FIG. 92 , the proximal outer shaft segment 8700 has aproximal end 8706 that has a slot 8708 for receiving the drive gear 8640therethrough such that the proximal outer shaft segment 8700 may moveaxially relative thereto. In addition, the proximal end 8706 of theproximal outer shaft segment 8700 has a flange 8710 formed thereon thatfacilitates rotational attachment to a closure carriage 8820 of anactuation system that is operably supported within the housing assembly8800. The closure carriage and actuation system may be of the same orsimilar type, construction and operation as the closure carriage andactuation system disclosed in U.S. Patent Application Publication No.2012/0074200 which has been incorporated by reference herein in itsentirety.

Referring now to FIG. 96 , the closure carriage 8820 may comprise twocarriage segments 8822 (only one is illustrated) that are interconnectedtogether by adhesive, snap features, screws, etc. As used herein, theterm “snap feature” includes, but is not limited to, for example, a tabthat has a protrusion thereon that is configured to retainingly engage acorresponding mating portion of another component. Such features may bedesigned to releasably engage the mating portion or it may not bedesigned or intended to be removed. In at least one form, the closurecarriage 8820 has a distal end 8824 that has a groove arrangement 8826that is adapted to receive the flanged end 8710 of the proximal outershaft segment 8700. Such arrangement serves to attach the proximal end8706 of the proximal outer shaft segment 8700 to the closure carriage8820 while facilitating its selective rotation of the proximal outershaft segment 8700 relative to the closure carriage 8820. Therefore, theelongated shaft assembly 8500 and the end effector 8412 that is operablycoupled thereto may be selectively rotated about the longitudinal toolaxis LT-LT relative to the housing assembly 8800.

In various implementations, the housing assembly 8800 comprises apistol-shaped handle housing that may be fabricated in two or morepieces for assembly purposes. For example, the housing assembly 8800 asshown comprises a right hand case member 8802 and a left hand casemember 8804 (FIG. 83 ) that are molded or otherwise fabricated from apolymer or plastic material and are designed to mate together. Such casemembers 8802 and 8804 may be attached together by snap features, pegsand sockets molded or otherwise formed therein and/or by adhesive,screws, etc. When assembled, the housing assembly 8800 movably supportsthe closure carriage 8820 for selective axial travel therein in responseto actuation motions from a trigger, generally designated as 8830. Asthe present Detailed Description proceeds, however, it will beunderstood that the various unique and novel aspects and attributes ofthe various implementations of the present invention may be effectivelyattained when employed with robotically controlled or otherwise remotelycontrolled systems. Thus, the term “housing” or “housing assembly” mayalso encompass a housing or similar portion of a robotic system thathouses or otherwise operably supports at least one drive system that isconfigured to generate and apply at least one control motion which couldbe used to actuate various forms of surgical end effectors attachedthereto. For example, various implementations of the surgical instrumentdescribed herein may be used in connection with those robotic systemsand arrangements disclosed in U.S. patent application Ser. No.13/536,323, entitled ROBOTICALLY POWERED SURGICAL DEVICE WITH MANUALLYACTUATABLE REVERSING SYSTEM, and filed Jun. 28, 2012, now U.S. Pat. No.9,408,606, the entire disclosure of which is incorporated by referenceherein.

The trigger assembly 8830 may, for example, comprise a primary trigger8840 and a secondary trigger 8860. The primary and secondary triggers8840 and 8860 are pivotally journaled on a pivot pin assembly 8831formed in the housing assembly 8800 such that the triggers 8840 and 8860may essentially move relative to each other. Such arrangement permitsthe trigger assembly 8830 to pivot relative to the housing assembly 8800about a pivot axis PA-PA. See FIG. 96 . The primary trigger 8840 has anelongated, grippable primary trigger paddle 8842 that protrudes from aprimary drive portion 8844 that has a firing rack 8846 formed thereon.In one embodiment, the secondary trigger 8860 has a secondary triggerpaddle 8862 that protrudes from a secondary drive portion 8864 asdiscussed in further detail that is pivotally journaled on the pivot pinassembly 8831. The primary drive portion 8844 has a slot 8848 that isadapted to receive the secondary drive portion 8864 of the secondarytrigger 8860 therein as the primary trigger paddle 8842 is pivotedtowards a pistol grip portion 8806 of the housing assembly 8800. Sucharrangement essentially enables the secondary trigger 8860 to “nest”within the primary trigger 8840 during actuation. As will be discussedin detail below, the secondary trigger 8860 is pivotally actuated bypivoting the primary trigger 8840. Thus, in other embodiments, thesecondary trigger 8860 may lack the secondary trigger paddle 8842. Invarious forms, the trigger assembly 8830 may be biased into theunactuated position by a trigger spring (not shown).

As can be seen in FIG. 96 , the secondary drive portion 8864 of thesecondary trigger 8860 may have a closure gear segment 8866 formedthereon that is configured for meshing engagement with a carriage gearrack 8823 formed on the underside of the closure carriage 8820. Thus,when the secondary trigger 8860 is pivoted toward the pistol grip 8806,the closure carriage 8820 is driven in the distal direction “DD”.

In various implementations, the actuation system 8810 may furtherinclude an actuation bar 8870. The actuation bar 8870 has a firstactuation rack 8872 formed thereon that is configured for meshingengagement with the primary gear segment 8846 on the primary trigger8840. Thus, when the primary gear segment 8846 is in meshing engagementwith the first actuation rack 8872, the actuation bar 8870 is driven inthe distal direction “DD” when the primary trigger 8840 is pivotedtoward the pistol grip 8806. The actuation bar 8870 has a secondactuation rack 8874 formed thereon configured to meshingly engage clutchteeth 8884 on a clutch shaft 8882 of a clutch assembly 8880. In variousembodiments, the clutch shaft 8882 is rotatably is supported within thehousing assembly 8800 and is also laterally movable therein. The clutchshaft 8882 has a hub portion 8886 that has a plurality of spaced teeth8888 that are configured to drivingly engage teeth openings 8892 in adrive gear 8890 that is rotatably supported on the clutch shaft 8882.The drive gear 8890 has a segment of drive gears 8894 thereon that areadapted for meshing engagement with a firing rack 8900 that is movablysupported in the housing assembly 8800.

Various embodiments of the clutch assembly 8880 may further comprise aclutch plate 8910 that is slidably journaled on a clutch pin 8849provided on the primary drive portion 8844 of the primary trigger 8840.The clutch pin 8849 may be movably received within a vertical slot 8912in the clutch plate 8910. The clutch plate 8910 also has adistally-extending clutch arm 8914 that is adapted to actuatably engagea bevel plate 8889 formed on the clutch shaft 8882. In addition, aclutch spring 8920 is employed to bias the clutch shaft 8880 laterallysuch that the teeth 8888 on the clutch shaft 8882 are brought intomeshing engagement with the teeth openings 8892 in the drive gear 8890.

As can be seen in FIGS. 92 and 96 , the firing rack 8900 is coupled to afiring rod 8930 that is attached to the proximal end of the knife barassembly 8970. In various embodiments, the knife bar assembly 8970 maycomprise an upper bar segment 8971 and a lower bar segment 8972. Sucharrangement may enable the knife bar assembly 8970 to flex as the endeffector 8412 is articulated, while remaining sufficiently rigid to bedriven distally through the shaft assembly 8500. In the depictedembodiment, the upper and lower knife bar segments 8971, 8972 are eachattached to an “E-beam” cutting head 8973. In the depictedconfiguration, the E-beam cutting head 8973 includes a verticallyoriented body portion 8974 that has an upper portion 8975 and a lowerportion 8976. A bottom foot 8977 is formed on or attached to the lowerportion 8976. In alternative embodiments, the bottom foot mayessentially comprise laterally extending lower tabs that protrudelaterally from the lower portion. Similarly, at least one upper tab8977′ is formed on or otherwise attached to the upper portion 8975 ofthe vertically oriented body portion 8974. In addition, as can be seenin FIG. 84 , the vertically oriented body portion 8974 further includesat least one intermediate tab portion 8978 (only one is shown) as wellas a tissue cutting edge 8979.

Referring to FIG. 84 , the vertically oriented body portion 8974 extendsthrough a longitudinally extending slot 8980 in the elongated channel8414 and a longitudinally extending slot 8981 in the anvil 8420. Whenassembled, portions of the elongated channel 8414 are received betweenthe bottom foot 8977 and the intermediate tab portions 8978. The, uppertab portion 8977′ is arranged to be received within the anvil 8420 aboveportions 8982 of the anvil 8420 that define the anvil slot 8981. Tofacilitate ease of assembly, the anvil 8420 may be provided with amovable anvil cover 8983 and the elongated channel 8414 may be providedwith a removable channel cover 8984. Once assembled, the anvil cover8983 and the channel cover 8984 may be installed to prevent tissue, bodyfluids, etc. from entering the anvil 8420 and the elongated channel8414, respectively which may hamper operation of the cutting head 8973.

In various arrangements, each staple cartridge 8430 includes a cartridgebody 8431 that has a sled assembly 8985 operably supported therein. Thesled assembly 8985 may have a mounting portion 8986 that is configuredto extend into a sled slot 8987 formed in the vertically oriented bodyportion 8974 of the cutting head 8973. See FIGS. 84 and 86 . The sledassembly 8985 may be configured with wedges 8988 that are arranged tocontact staple drivers 8989 that are operably supported within thestaple cartridge 8430. The staple drivers 8989 may support one or morestaples 8990 thereon in a known manner. As the sled assembly 8985 isdriven in the distal direction DD through the staple cartridge 8430, thewedges 8988 drive the drivers 8989 upward within the cartridge 8430 in aknown manner. The upwardly moving drivers 8989 drive the staples 8990into forming contact with a staple forming undersurface of the anvil8420. The undersurface may, for example, include staple-forming pocketsthat correspond to each staple.

The end effector 8412 may also employ a cutting head lockout system,generally designated as 8991 that serves to prevent distal advancementof the cutting head 8973 when a new staple cartridge 8430 is not presentwithin the elongated channel 8414. In at least one arrangement, forexample, the cutting head lockout system 8991 may comprise a lockoutspring 8992 that is mounted to the bottom of elongated channel 8414. Thelockout spring 8992 may be configured to contact the bottom foot 8977 ofthe cutting head assembly 8973 when the cutting head assembly 8974 is inthe starting position. See FIGS. 86, 88 and 91 . An opening 8993 may beprovided through the bottom of the elongated channel 8414 such that whenin that position, the lockout spring 8992 biases the bottom foot 8977such that it interferes with the bottom of the elongated channel 8414.Thus, when the bottom foot 8977 is in that position, if the clinicianwere to try advance the cutting head 8973 distally through the elongatedchannel 8414, the bottom foot portion 8977 will contact a portion of theelongated channel 8414 to prevent such advancement of the cutting head8973. When a cartridge 8430 has been properly installed with theelongated channel 8414, the mounting portion 8986 of the sled assembly8985 extends into the sled slot 8987 and serves to move the cutting headassembly 8973 into a position whereby the foot portion 8977 is moved outof interfering contact with the bottom of the elongated channel 8414.When in that position, the cutting head assembly 8973 is free to beadvanced distally through the elongated channel 8414. Such arrangementserves to prevent the clinician from inadvertently firing the endeffector when a new cartridge is not present which could otherwiseresult in the tissue being cut but not stapled. As the cutting head 8973is advanced distally, the bottom foot 8977, the intermediate tabportions 8978 and the upper tab 8977′ cooperate to orient the anvil 8420relative to the staple cartridge deck at a desired spaced relationshiprelative to each other. A distally presented tissue-cutting edge 8979,which is between the upper tab 8977′ and intermediate tab portions 8978,severs clamped tissue while causing the staples 8990 within the staplecartridge 8430 to be formed into the tissue clamped within the endeffector 8412.

As can be seen in FIG. 84 , the upper firing bar 8971 is attached to theupper end portion 8975 and the lower firing bar 8972 is spaced from theupper firing bar 8971 and is attached to the lower end portion 8976 ofthe vertically-extending 8974 of the cutting head 8973. Such arrangementserves to transmit the firing motions to the upper and lower portions ofthe cutting head 8973 in an equivalent manner to facilitate alignedmovement of the cutting head through the anvil 8420, the surgical staplecartridge 8430 and the elongated channel 8414. In various arrangements,for example, the upper firing bar 8971 may be attached to the upper endportion directly behind the upper tabs(s) 8977′ such that the upperfiring bar 8971 is essentially axially aligned with point(s) from whichthe upper tab(s) 8977′ protrude laterally from the upper end portion8975. Similarly, the lower firing bar 8972 may be attached to the bottomend portion 8976 directly behind the bottom foot 8977 or the point(s)from which the laterally protruding bottom tabs protrude laterally fromthe bottom end portion 8976 such that the lower firing bar 8972 isaxially aligned therewith. The upper and lower firing bars 8971, 8972may be welded to the vertical extending portion 8974 in those locations.For example, the welds may be applied to the firing bars from one sideor from both lateral sides of the firing bars. In at least oneimplementation, the upper and lower firing bars 8971, 8972 are notdirectly attached to each other. The portions of the upper and lowerfiring bars 8971, 8972 that extend through the elongated shaft assembly8500 to be coupled to a distal end portion 8932 of the firing rod 8930are supported in a contiguous orientation relative to each other. Theproximal ends of the upper and lower firing bars 8971, 8972 may beattached to the distal end portion 8932 of the firing rod 8930 by acoupler member 8994. See FIG. 92 . As will be discussed in furtherdetail below, the firing rod 8930 facilitates the application of firingand retraction motions to the knife bar assembly 10600 by the actuationsystem 8810. In at least one implementation, the anvil mounting portion8422 has a wedge-like formation 8427 thereon that serves to separate theupper firing bar 8971 and lower firing bar 8972 as the knife barassembly 8970 is driven in the distal direction “DD”. See, for example,FIG. 91 .

In various arrangements, the firing rod 8930 extends through a closurebushing 8940 that is mounted within the housing assembly 8800. In atleast one form, a pair of mounting studs 8807 protrude from the handlecasings 8802, 8804 and extend through corresponding slots in the closurecarriage 8820 to be received in a retaining slot in the bushing 8840. Aclosure spring 8950 that is attached to a retainer clip 8952 isjournaled on the closure bushing 8940. The closure spring 8950 extendsbetween the nozzle body 8652 and an internal wall 8825 in the closurecarriage 8820. Thus, the closure spring 8950 serves to bias the closurecarriage 8820 in the proximal direction “PD”.

Various embodiments may also include a releasable closure lockingassembly 8960 that interfaces with the closure carriage 8820 toselectively retain the closure carriage 8820 in its distal-most closedor clamped position. In at least one form, the closure locking assembly8960 includes a locking button 8962 that is pivotally supported in thehousing assembly 8800. The locking button 8862 has a latch arm 8964 thatis configured to abut a locking ledge 8826 formed on the closurecarriage 8820 when the button 8962 is in the locked position. Inaddition, the latch arm 8964 has a catch 8966 formed thereon that isconfigured to releasably latch with a locking latch 8902 on the proximalend of the firing rack 8900. A locking spring 8968 serves to bias thelocking button 8962 into the locked position.

Operation of the surgical instrument 8410 will now be described. FIGS.89-91 illustrate the jaws 8413 and 8415 of the end effector 8412 in anopen position. When the end effector 8412 is in the open position, thelatch arm 8964 is located on top of the locking ledge 8826 formed on theclosure carriage 8820 such that the catch 8966 of the latch arm 894 isin retaining engagement with the locking latch 8902 on the firing rack8900. Thus, when in this initial starting position, the knife barassembly 8790 cannot be inadvertently actuated. The clutch plate 8910,as well as the closure carriage, are each in their proximal-mostunactuated positions. When in those positions, the clutch drive bevel8889 on the clutch shaft 8882 is in contact with a portion of theclosure carriage 8820, which prevents the clutch shaft 8882 fromlaterally moving into meshing engagement with the drive gear 8890 underthe bias of the clutch spring 8920.

To initiate the closure process, a first stroke is applied to thetrigger assembly 8830. That is, the trigger assembly 8830 is initiallypivoted toward the pistol grip 8806. Such pivoting action serves todrive the closure carriage 8820 in the distal direction “DD” by virtueof the meshing engagement between the closure gear segment 8866 on thesecondary trigger 8860 and the carriage rack 8823 formed on theunderside of the closure carriage 8820. Such distal movement of theclosure carriage 8820 also axially advances the proximal outer shaftsegment 8700 and the distal closure tube segment 8590 in the distaldirection “DD”. As the distal closure tube segment 8590 moves distally,the pin 8419 which extends through the slots 8423 in the anvil mountingportion 8422, travels from the position illustrated in FIGS. 90 and 91to the position illustrated in FIGS. 86-88 to pivot the anvil 8420 tothe closed position. If the surgeon desires to simply grasp andmanipulate tissue prior to clamping it between the anvil 8420 and thesurgical staple cartridge 8430, the trigger assembly 8830 may be pivotedto open and close the anvil 8420 without fully pivoting the triggerassembly 8830 to the fully closed position.

Those of ordinary skill in the art will understand that, as the triggerassembly 8830 is pivoted toward the pistol grip 8806, the actuation bar8870 will necessarily also be driven distally by virtue of the meshingengagement between the primary gear segment 8846 on the primary trigger8840 and the first actuation rack 8872 on the actuation bar 8870. Thedistal movement of the actuation bar 8870 will also result in the anapplication of a rotary actuation motion to the clutch shaft 8882 byvirtue of the meshing engagement between the clutch teeth 10484 on theclutch shaft 8882 and the second actuation rack 8874 on the actuationbar 8870. However, such rotary motion is not applied to the drive gear8890 because the clutch arm 8914 of the clutch plate 8910, in contactwith the clutch drive bevel 8889 on the clutch shaft 8882, prevents theaxial movement of the clutch shaft 8882 into meshing engagement with thedrive gear 8890. Thus, the clutch shaft 8882 freely rotates relative tothe drive gear 8890. Accordingly, the clutch assembly 8880 automaticallyprevents the activation of the firing rack 8900 during the initialactuation of the trigger assembly 8830.

Once the trigger assembly 8830 has been initially fully compressed intothe closed position, the anvil 8420 will be retained in the locked orclamped position by the closure locking assembly 8960 which prevents theproximal movement of the closure carriage 8820. To drive the knife barassembly 8970 distally through the tissue clamped in the end effector8412, the surgeon again pivots the primary trigger 8840 toward thepistol grip 8806 of the housing assembly 8800. As the primary trigger8840 is pivoted, the firing rack 8900, the firing rod 8930, and theknife bar assembly 10600 are driven in the distal direction “DD”. Afterthe knife bar assembly 8970 has been driven through the tissue clampedin the end effector 8412, the surgeon then releases the primary trigger8840 to thereby permit the primary trigger 8840 to pivot to itsunactuated position under the bias of the firing spring 8832. As theprimary trigger 8840 pivots back to the starting position, the firingrack 8900, firing rod 8930, and knife bar assembly 8970 are drawnproximally back to their respective starting positions. The end effector10012 remains in its clamped position as shown in FIG. 88 . As can alsobe seen in that Figure, the sled assembly 8985 remains in the distal endof the cartridge 8430 while the knife bar assembly 8970 is returned tothe starting position.

To unlock the closure carriage 8820 and the secondary trigger 8860, thesurgeon depresses the locking button 8962. As the locking button 8962 isdepressed, the locking arm 8964 is pivoted out of abutting engagementwith the locking ledge 8826 on the closure carriage 8820. Furtherdetails regarding the operation of the firing and closure systems may befound in U.S. Patent Application Publication No. 2012/0074200 which hasbeen herein incorporated by reference in its entirety. As the closurecarriage 8820 moves proximally, the proximal outer shaft segment 8700,the flexible neck assembly 8510, and the distal closure tube segment8590 are drawn proximally. As the distal closure tube segment 8590 movesproximally, the shaft 8419 travels proximally within the slot 8423 inthe anvil mounting portion 8422 to move the anvil 8420 to an openposition.

As can be appreciated from the foregoing, the various surgicalinstruments disclosed herein afford the clinician with improvedmaneuverability and various other advantages that are not available whenusing prior surgical instruments that are configured to cut and fastentissue. For example, in various implementations disclosed herein, theend effector is selectively articulatable in the same directions inwhich the jaws are movable relative to each other. Stated another way,the jaws of the surgical end effector are constrained to move in oneplane. In various implementations disclosed herein, the end effector isalso capable of moving in that same plane. Prior end effectors arecommonly constrained to move in planes that differ from the plane inwhich the jaws move.

Another advantage provided by many of the present implementations is theuse of a firing bar that comprises at least an upper firing bar and atleast a lower firing bar that form a laminated structure. The upper andlower bars may at some point be attached to each other or they may beunattached and just be contiguous with each other. In eitherarrangement, the upper bar is attached to an upper end of the cuttinghead and the lower bar may be attached to the lower head such that theyare spaced from each other at their points of attachment to the cuttinghead. Such arrangement serves to provide for a more stable cutting headarrangement that may be less likely to twist and/or buckle duringactuation. In addition, the cutting head may be equipped with laterallyprotruding upper tab(s) that engage a portion of the anvil and lowertab(s) that engage the elongated channel. The upper firing bar may beattached directly behind the point where the upper tabs are attachedsuch that it is axially aligned therewith. Likewise the lower firing barmay be attached to the bottom portion directly behind the points wherethe bottom tab(s) are attached such that it is axially alignedtherewith. Such axial alignment facilitates transfer of the driving oractuation motions to the cutting head at the points where the cuttinghead engages the anvil and the elongated channel which may furtherprevent and buckling and/or twisting of the cutting head duringactuation.

The various surgical instruments arrangements disclosed herein thatemploy tissue cutting and staple firing systems, jaw opening and closingsystems and end effector articulation systems that essentially employcomponents that are axially reciprocated during actuation may beactuated by manually generated actuation motions, For example, thefiring systems may be housed in a handle that includes triggerarrangements that are configured to generate actuation motions when theclinician manipulate the triggers. It will be appreciated, however, thatsuch actuation motions may likewise be generated by motors that aresupported in a handle or are supported or comprise a portion of arobotic system. Thus, the various surgical instruments disclosed hereinshould not be limited to use solely in connection with hand-heldhousings and manually generated actuation motions.

Powered surgical instruments are disclosed in U.S. Patent ApplicationPublication No. 2009/0090763, filed on Aug. 12, 2008, and entitledPOWERED SURGICAL STAPLING DEVICE to Zemlok et al. (hereinafter “Zemlok'763”), the entire disclosure of which is hereby incorporated byreference herein. Powered surgical instruments are also disclosed inU.S. Patent Application Publication No. 2011/0278344, filed on Mar. 9,2011, and entitled POWERED SURGICAL INSTRUMENT to Zemlok et al.(hereinafter “Zemlok '344”), now U.S. Pat. No. 8,201,721, the entiredisclosure of which is hereby incorporated by reference herein. FIG. 97illustrates a powered surgical instrument 9010 that, in many ways, maybe similar to those surgical instruments (including various features,components and subcomponents thereof) disclosed in, for example, Zemlok'763 and/or Zemlok '344, which have each been incorporated by referenceherein in their respective entireties. Likewise, the surgical instrument9010 may be similar to those surgical instruments disclosed in U.S.patent application Ser. No. 13/974,166, filed Aug. 23, 2013, andentitled FIRING MEMBER RETRACTION DEVICES FOR POWERED SURGICALINSTRUMENTS to Shelton et al. (hereinafter, “Shelton '166”), now U.S.Pat. No. 9,700,310, the entire disclosure of which is herebyincorporated by reference herein. The surgical instrument 9010 depictedin FIG. 97 includes a housing 9012 that has a handle portion 9014 forfacilitating manual manipulation and operation of the instrument. Thus,the term “housing” as used herein may encompass a handheld or otherwisehand-manipulatable arrangement. However, the term “housing” may alsoencompass portions of an automated surgical instrument system such as arobotically-controlled system that is not intended to be handheld but isotherwise manipulated and actuatable by various components, portions,and/or actuators of the system. For example, various implementations ofthe surgical instrument described herein may be used in connection withthose robotic systems and arrangements disclosed in U.S. patentapplication Ser. No. 13/536,323, entitled ROBOTICALLY POWERED SURGICALDEVICE WITH MANUALLY ACTUATABLE REVERSING SYSTEM, and filed Jun. 28,2012, now U.S. Pat. No. 9,408,606, the entire disclosure of which isincorporated by reference herein. Furthermore, the coupling arrangementsand end effector arrangement disclosed herein may also be effectivelyemployed with non-powered hand held surgical instruments. Thus, the endeffector arrangements and coupling arrangements disclosed herein shouldnot be limited to use in connection with powered instruments, whetherthey be hand-held or otherwise automated.

An elongated shaft assembly 9116 in the form of an endoscopic portionprotrudes from the housing 9012 and is configured for operableattachment to a surgical end effector that is constructed to perform atleast one surgical procedure in response to applications of firingmotions thereto. The surgical end effector may comprise a deviceconfigured to cut and staple tissue such as a “loading unit” 9020 asshown in FIGS. 98-105 . Surgical end effectors, such as loading unit9020, for example, can be releasably attached to the elongated shaftassembly 9116 of the powered surgical instrument 9010, as described ingreater detail herein.

FIGS. 98-105 illustrate one exemplary form of end effector or loadingunit 9020 that may be employed with the surgical instrument 9010. As canbe seen in FIG. 100 , the loading unit 9020 includes an anvil assembly9220 that is supported for pivotal travel relative to a carrier 9240that operably supports a staple cartridge 9260 therein. The staplecartridge 9260 may comprise a surgical staple cartridge that is designedto be “implanted” within the patient. For example, the implantablesurgical staple cartridge 9260 may comprise any of the various surgicalstaple cartridge arrangements disclosed in U.S. Patent ApplicationPublication No. 2012/0080484, filed Sep. 30, 2010, and entitled SURGICALSTAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM, now U.S. Pat.No. 9,113,862, the entire disclosure of which is hereby incorporated byreference herein. In at least one implementation for example, the staplecartridge 9260 includes a body portion 9261 that consists of acompressible hemostat material such as, for example, oxidizedregenerated cellulose (“ORC”) or a bio-absorbable foam in which lines ofunformed metal staples are supported. In at least some embodiments, inorder to prevent the staple from being affected and the hemostatmaterial from being activated during the introduction and positioningprocess, the entire cartridge may be coated or wrapped in abiodegradable film such as a polydioxanon film sold under the trademarkPDS® or with a Polyglycerol sebacate (PGS) film or other biodegradablefilms formed from PGA (Polyglycolic acid, marketed under the trade markVicryl), PCL (Polycaprolactone), PLA or PLLA (Polylactic acid), PHA(polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under thetrademark Monocryl) or a composite of PGA, PCL, PLA, PDS that would beimpermeable until ruptured. The body 9261 of staple cartridge 9260 issized to be removably supported within the carrier 9240 as shown suchthat each staple therein is aligned with corresponding staple formingpockets in the anvil assembly 9220.

The anvil assembly 9220 has a pair of trunnions 9221 formed thereon thatare adapted to be pivotally received within trunnion slots 9242 in aproximal end 9241 of the carrier 9240 such that the anvil assembly 9220may move or pivot between an open position and a closed positionrelative to the carrier 9240 about an anvil pivot axis ANV-ANV. Theanvil pivot axis ANV-ANV is transverse to a longitudinally extendingtool axis LA-LA defined by the elongated shaft assembly 9116. When theanvil assembly 9220 is pivoted from an open position to a closedposition, the anvil assembly 9220 is moving in a closing direction “CD”about anvil pivot axis ANV-ANV. Conversely, when the anvil assembly 9220is moving from a closed position to an open position, the anvil assembly9220 is moving in an opening direction “OD” about anvil pivot axisANV-ANV.

The loading unit 9020 employs a unique and novel articulation joint 9270that facilitates articulation of the carrier 9240 and anvil assembly9220 to pivot about an articulation axis “AA-AA” that is transverse to alongitudinal tool axis “LA-LA”. For example, the loading unit 9020 mayinclude an end effector housing 9400 that is configured to be receivedwithin an outer casing 9450. The distal end 9402 of the end effectorhousing 9400 may have a clevis 9404 formed thereon by two distallyprotruding tabs 9406. Each tab 9406 has a pivot hole 9408 formed thereinthat is adapted to receive therein a corresponding pivot pin 9274 formedon an articulation ball assembly 9272. See FIG. 100 . The articulationball assembly 9272 may be rigidly affixed to the proximal end 9241 ofthe carrier 9240 by, for example, welding or other suitable fasteningarrangement. As will be discussed in further detail below, whenassembled together, the carrier 9240 and anvil assembly 9220 canselectively articulate as a unit about the articulation axis AA-AA in afirst direction “FD” which is the same direction as the anvil closingdirection “CD” and in a second direction “SD” which is the same as theanvil opening direction “OD”. See FIG. 105 .

Still referring to FIG. 100 , the end effector housing 9400 may beprovided with a channel 9410 for slidably receiving an articulation link9420 therein. The articulation link 9420 includes a proximal end portion9422 and a distal end 9424. Fixedly attached to the distal end portion9424 is an articulation tube 9426. The articulation tube 9426 maycomprise a hollow tube and be attached to the distal end 9424 by, forexample, welding or other suitable means. As can be seen in FIG. 102 ,the articulation tube 9426 may have a series of articulation teeth 9428formed therein that are configured to meshingly engage sets of distalarticulation teeth 9276 formed on the articulation ball 9272. Thus,movement of the articulation link 9420 in the distal direction “DD” willcause the carrier 9240 and anvil assembly 9220 to pivot in the firstdirection “FD” about the articulation axis AA-AA. Conversely, movementof the articulation link 9420 in the proximal direction “PD” will causethe carrier 9240 and anvil assembly 9220 to pivot as a unit in thesecond direction “SD” about the articulation axis AA-AA. Thearticulation link 9420 and the articulation tube 9426 may becollectively referred to herein as the articulation link assembly 9425.See FIG. 100 .

The loading unit 9020 may also be equipped with a drive assembly 9460that is configured to axially move through the end effector housing9400. In at least one implementation, the drive assembly 9460 includes adrive beam assembly 9461 that includes an upper drive beam 9462 and alower drive beam 9464 that are attached to a cutting head 9470. Thecutting head 9470 may include a body portion 9471 that has a tissuecutting edge 9472 formed thereon. An upper portion 9473 of the bodyportion 9471 has an upper tab 9474 formed thereon. A bottom foot or tab9476 is formed on a lower portion 9475 of the body portion 9471. Thevertically oriented body portion 9471 extends through a longitudinallyextending slot 9245 in the carrier 9240 and a longitudinally extendingslot 9222 in the anvil assembly 9220. When assembled, the bottom foot9476 is configured to slide along the bottom of the carrier 9240. The,upper tab portion 9474 is arranged to be slidably received within anelongated channel 9223 formed in the anvil assembly 9220.

As can be seen in FIG. 100 , the upper firing bar 9462 is attached tothe upper end portion 9473 and the lower firing bar 9464 is spaced fromthe upper firing bar 9462 and is attached to the lower end portion 9475of the vertically-extending portion 9471 of the cutting head 9470. Sucharrangement serves to transmit the firing motions to the upper and lowerportions of the cutting head 9470 in an equivalent manner to facilitatealigned movement of the cutting head 9470 through the anvil assembly9220, the surgical staple cartridge 9260 and the carrier 9240. Invarious arrangements, for example, the upper firing bar 9462 may beattached to the upper end portion 9473 directly behind the upper tabs(s)9474 such that the upper firing bar 9462 is essentially axially alignedwith point(s) from which the upper tab(s) 9474 protrude laterally fromthe upper end portion 9473. Similarly, the lower firing bar 9464 may beattached to the bottom end portion 9475 directly behind the bottom foot9476 or the point(s) from which the laterally protruding bottom tabs9476 protrude laterally from the bottom end portion 9475 such that thelower firing bar 9464 is axially aligned therewith. The upper and lowerfiring bars 9462, 9464 may be welded to the vertical extending portion9471 in those locations. For example, the welds may be applied to thefiring bars from one side or from both lateral sides of the firing bars.As the cutting head 9470 is driven distally in the distal direction“DD”, the anvil assembly 9220 is pivoted closed between the uppertabs(s) 9474 and the lower tab(s) or foot 9476. Further advancement ofthe cutting head assembly 9470 causes the surgical staple cartridge 9260to be crushed between the anvil assembly 9220 and the carrier 9240thereby causing the surgical staples supported therein to be formed onboth sides of the tissue cut line as they are brought into contact withthe staple forming underside of the anvil assembly 9220. After thecutting head assembly 9470 has been advanced to the distal end of thecarrier 9240, the user retracts the cutting head assembly 9470 to thestarting position whereupon the anvil assembly 9220 may be opened torelease the staple cartridge 9260 and stapled tissue. In oneimplementation, for example, the upper tab(s) 9474 are configured tointeract with the upper surface of the anvil assembly 9220 to cam orpivot the anvil assembly 9220 back to the open position. In alternativearrangements, a spring or other biasing member (not shown) may beemployed to bias the anvil assembly 9220 to the open position when thecutting head assembly 9470 is in a starting position.

The drive beam assembly 9460 may further include a proximal engagementmember 9467 that includes a pair of engagement fingers 9468 that areconfigured to operably engage a distal end 9522 of a firing rod 9104 aswill be discussed in further detail herein. As can be seen in FIG. 100 ,for example, the proximal engagement member 9467 is pivotally coupled tothe upper and lower firing bars 9462, 9464 to facilitate articulationand flexing thereof during articulation of the carrier 9240 about thearticulation axis AA-AA without binding the drive beam assembly 9461. Inat least one implementation, for example, the proximal engagement member9467 is pivotally coupled to the upper and lower firing bars 9462, 9464by a pair of pivot links 9466. Such links 9466 enable the upper firingbar 9462 to pivot relative to the proximal engagement member 9467independent form the lower firing bar 9464 and vice versa.

As can be seen in FIG. 97 , the surgical instrument 9010 may include amotor 9100 that is configured to generate rotary actuation motions thatmay be employed, for example, to apply firing motions to the loadingunit 9020 as will be discussed in further detail below. In at least oneform, for example, the motor 9100 is configured to apply rotaryactuation motions to a firing member assembly, generally designated as9082. In one arrangement, for example, the firing member assembly 9082includes a drive tube 9102 that is rotatably supported within thehousing 9012 and has an internal thread (not shown) formed therein. Aproximal threaded portion of a firing member or firing rod 9104 issupported in threaded engagement with the drive tube 9102 such thatrotation of the drive tube 9102 results in the axial movement of thefiring rod 9104. The firing rod 9104 may interface with the interior ofthe drive assembly 9460 in the loading unit 9020. As discussed infurther detail in the aforementioned incorporated Zemlok '763 and Zemlok'344, rotation of drive tube 9102 in a first direction (e.g.,counter-clockwise) causes the firing rod 9104 to advance the driveassembly 9460 in the distal direction.

As can be further seen in FIG. 97 , the surgical instrument 9010 mayinclude an articulation system generally designated as 9109. However,surgical instrument 9010 may include various other articulation systemarrangements disclosed in detail herein. In at least one form, thearticulation system 9109 may include an articulation mechanism 9110 thatincludes an articulation motor 9112 and a manual articulation knob 9114.The articulation motor 9112 may be actuated by a powered articulationswitch 9116 or by pivoting the manual articulation knob 9114. Actuationof the articulation motor 9112 serves to rotate an articulation gear9118 of the articulation mechanism 9110. Actuation of articulationmechanism 9110 may cause the end effector (e.g., the cartridge/anvilportion of the loading unit 9020) to move from its first position,wherein its axis is substantially aligned with longitudinal tool axis“LA-LA” of the elongated shaft assembly 9116 to a position in which theaxis of the end effector is disposed at an angle relative to thelongitudinal tool axis “LA-LA” of the elongated shaft assembly about,for example, articulation axis “AA-AA”. Further discussion regardingvarious aspects of the articulation mechanism 9110 may be found inZemlok '763 which was previously incorporated by reference herein in itsentirety. In addition, U.S. Pat. No. 7,431,188, entitled SURGICALSTAPLING APPARATUS WITH POWERED ARTICULATION, and filed Mar. 15, 2007,the entire disclosure of which is hereby incorporated by referenceherein, discloses motor-powered articulatable end effectors which may beemployed in connection with surgical instrument 9010. Those of ordinaryskill in the art will understand, however, that the unique and novelcoupling and end effector arrangements disclosed herein may also beeffectively employed with manually-operated (i.e., non-powered)articulation systems that are known in the art.

In various embodiments, the surgical instrument can include at least onemotor, which can apply firing motions to the loading unit 9020 and/orarticulation motions to the articulation system 9109, as describedelsewhere in greater detail. The motor 9100 may, for example, be poweredby a power source 9200 of the type described in further detail in Zemlok'763. For example, the power source 9200 may comprise a rechargeablebattery (e.g., lead-based, nickel-based, lithium-ion based, etc.). It isalso envisioned that the power source 9200 may include at least onedisposable battery. The disposable battery may, for example, be betweenabout 9 volts and about 30 volts. However, other power sources may beemployed. FIG. 97 illustrates one example wherein the power source 9200includes a plurality of battery cells 9202. The number of battery cells9202 employed may depend upon the current load requirements of theinstrument 9010.

Referring to FIG. 97 , a power source such as, for example, the powersource 9200 can supply power for operation of the surgical instrument9010. For example, the power source 9200 can supply power for a motorsuch as, for example, motor 9100 to cause rotation of the drive tube9102 in a first direction and ultimately the axial advancement of thefiring rod 9104 which drives the drive assembly 9460 distally throughthe loading unit 9020. Alternatively, the power source 9200 can supplypower for the motor 9100 to cause rotation of the drive tube 9102 in asecond direction opposite the first direction and ultimately the axialretraction of the firing rod 104 which can move the drive beam 9060proximally to its starting and/or default position.

Surgical end effectors, such as a disposable loading unit 9020, forexample, can be operably coupled to the elongated shaft assembly 9116 ofthe powered surgical instrument 10010 (FIG. 1 ). In various embodiments,the surgical instrument 9010 can include an elongated shaft assembly9116, which can engage the loading unit 9020, for example. In variousembodiments, a coupling assembly 9115 that includes a rotatable couplingcollar 9500, for example, can releasably lock the loading unit 9020relative to the elongated shaft assembly 9116. Furthermore, in variousembodiments, rotation of the coupling collar 9500 can facilitateattachment and/or alignment of a firing assembly and/or an articulationassembly, as described herein. In various embodiments, the loading unit9020 can include a distal attachment portion 9480 and the elongatedshaft assembly 9116 can include an outer tube 9030 and a distalattachment portion 9032. The distal attachment portion 9480 of theloading unit 9020 can receive the distal attachment portion 9032 of theshaft assembly 9116 when the loading unit 9020 is secured to theelongated shaft assembly 9116 (FIG. 107 ). Furthermore, the rotatablecoupling collar 9500 can be positioned around the distal attachmentportion 9032 of the shaft assembly 9116, such that the distal attachmentportion 9480 of the loading unit 9020 can also be positioned within therotatable coupling collar 9500. The rotatable coupling collar 9500 canbe secured to the elongated shaft assembly 9116 and/or the proximalattachment portion 9480, and, in certain embodiments, can be rotatablyfixed to the distal attachment portion 9032 of the shaft assembly 9116,for example. In certain embodiments, a proximal attachment portion ofthe shaft assembly 9116 can receive a distal attachment portion 9480 ofthe loading unit 9020 when the loading unit 9020 is secured to the shaftassembly 9116. Furthermore, in certain embodiments, a coupling collar9500 can be rotatably fixed to the loading unit 9020.

Referring to FIGS. 106 and 107 , as the loading unit 9020 moves betweena non-attached position and an attached position relative to theelongated shaft assembly 9116 of the surgical instrument 9010, theloading unit 9020 can translate along a longitudinal tool axis LA-LA asdefined by the elongated shaft assembly 9116. The distal attachmentportion 9480 of the loading unit 9020 can be inserted into the distalattachment portion 9032 of the elongated shaft assembly 9116 as theloading unit 9020 moves from the non-attached position to the attachedposition. For example, the loading unit 9020 can translate in proximaldirection “PD” (FIG. 107 ) when the loading unit 9020 is moved betweenthe non-attached position and the attached position. In certainembodiments, a groove-and-slot engagement between the distal attachmentportion 9480 and the distal attachment portion 9032 can guide theloading unit 10020 along the longitudinal tool axis LA-LA defined by theelongated shaft assembly 9116. Referring primarily to FIG. 110 , thedistal attachment portion 9480 can include a guide rail 9482.Furthermore, referring primarily to FIG. 112 , the distal attachmentportion 9032 can include a guide slot 9034. The guide slot 9034 can bedimensioned and structured to receive and guide the guide rail 9482 asthe proximal attachment portion 9480 of the loading unit 9020 isinserted into the distal attachment portion 9032 of the elongated shaftassembly 9116. For example, the guide slot 9034 can comprise alongitudinal slot, and the guide rail 9482 can comprise a longitudinalridge, for example. In certain embodiments, the guide slot 9034 andguide rail 9482 can prevent twisting and/or rotating of the loading unit9020 relative to the longitudinal tool axis LA-LA.

Referring primarily to FIG. 106 , the distal attachment portion 9480 caninclude a first alignment indicia 9484, such as a first arrow, forexample, and the elongated shaft assembly 9116 and/or the couplingcollar 9500 can include a second alignment indicia 9502, such as asecond arrow, for example. Alignment of the first and second alignmentindicia 9484, 9502 can align the guide rail 9482 and the guide slot9034, which can facilitate attachment of the distal attachment portion9480 to the distal attachment portion 9032. As described herein,translation of the loading unit 9020 along a longitudinal path towardthe elongated shaft assembly 9116 can releasably lock the loading unit9020 relative to the elongated shaft assembly 9116. In such embodiments,rotation of the loading unit 9020 relative to the elongated shaftassembly 9116 may not be required to attach the loading unit 9020relative to the elongated shaft assembly 9116. In fact, rotation of theloading unit 9020 relative to the elongated shaft assembly 9116 can berestrained and/or prevented by a groove-and-slot engagement between thedistal attachment portion 9032 and the distal attachment portion 9480,as described herein. In various embodiments, the coupling collar 9500can rotate relative to the loading unit 9020 and/or the elongated shaftassembly 9116 to releasably lock the loading unit 9020 to the elongatedshaft assembly 9116. For example, as described herein, the couplingcollar 9500 can rotate from an initial orientation (FIG. 120 ) toward asecondary orientation (FIG. 121 ) and then return toward the initialorientation (FIG. 124 ) to lock the loading unit 9020 to the elongatedshaft assembly 9116.

Referring primarily to FIGS. 110 and 111 , the proximal portion 9480 ofthe loading unit 9020 can include a rotation key or rib 9486. As theloading unit 9020 is moved in the proximal direction “PD” (FIG. 106 )between a non-attached position (FIG. 106 ) and an attached position(FIG. 107 ), the rotation key 9486 can affect rotation of the couplingcollar 9500. For example, the rotation key 9486 can rotate and/or biasthe coupling collar 9500 in direction B (FIG. 107 ) from the initialorientation to the secondary orientation. The distal attachment portion9480 can be inserted into the distal attachment portion 9032 when thecoupling collar 9500 is biased into the secondary orientation.Furthermore, when the distal attachment portion 9480 is fully insertedinto the distal attachment portion 9032, the rotation key 9486 canpermit the coupling collar 9500 to rotate in direction C (FIG. 107 )from the secondary orientation toward the initial orientation. As usedherein the term “fully inserted” as used with respect to the coupling ofthe loading unit 9020 to the elongated shaft assembly 9116 means thatthe distal attachment portion 9480 of the loading unit 9020 has beenfully inserted in mating or operational engagement with the distalattachment portion 9032 of the elongated shaft assembly 9116. DirectionC can be opposite to direction B, for example. As described herein, whenthe coupling collar 9500 returns to the initial orientation, thecoupling collar 9500 can lock the distal attachment portion 9480relative to the distal attachment portion 9032. Referring to FIGS. 110and 111 , the rotation key 9486 can include a rotation ramp 9488 at theproximal end thereof. The rotation ramp 9488 can engage an element ofthe shaft assembly 9116 to effect rotation of the rotation couplingcollar 9500, for example.

In various embodiments, the rotation ramp 9488 can affect rotation of afiring shaft 9104 positioned within the elongated shaft assembly 9116.For example, referring primarily to FIGS. 115-118 , the firing shaft9104 can include a firing shaft rotator 9600 which can extend radiallyoutward from the firing shaft 9104. The rotation ramp 9488 of therotation key 10486 can engage the firing shaft rotator 9600 when theloading unit 9020 is inserted into the elongated shaft assembly 9116. Invarious embodiments, the rotation ramp 9448 can rotate the firing shaftrotator 9600, which can rotate the firing shaft 9104. For example, thefiring shaft 104 and the firing shaft rotator 9600 can rotate indirection B between a first orientation (FIG. 121 ) and a secondorientation (FIG. 122 ). Referring still to FIGS. 115-118 , the firingshaft 9104 can be engaged with the rotatable coupling collar 9500. Forexample, the rotatable coupling collar 9500 can include a rotator groove9502, which can be structured and dimensioned to receive and/or hold thefiring shaft rotator 9600. The firing shaft rotator 9600 can be held bythe rotator groove 9600, such that the rotation of the firing shaftrotator 9600 rotates the rotatable coupling collar 9500. In suchembodiments, insertion of the loading unit 9020 into the elongated shaftassembly 9116, can affect rotation of the rotatable coupling collar 9500in direction B (FIG. 122 ) via rotation of the firing shaft rotator 9600in direction B, for example.

Referring primarily to FIGS. 112 and 113 , the distal attachment portion9032 can include a rotation key slot 9510, which can receive therotation key 9486 when the distal attachment portion 9480 is insertedinto the distal attachment portion 9032. In various embodiments, therotation key slot 9510 can include a clearance notch 9512 for receivingthe firing shaft rotator 9600. For example, the rotation ramp 9488 atthe proximal end of the rotation key 9486 can rotate the firing shaftrotator 9600 to the second orientation and into the clearance notch 9512(FIG. 122 ). The rotation key 9486 can continue to move along therotation key slot 9510 as the loading unit 9020 is inserted into theelongated shaft assembly 9116. Furthermore, when the distal end 9490 ofthe rotation key 9486 moves past the firing shaft rotator 9600, thefiring shaft rotator 9600 can rotate back toward the first orientation(FIG. 126 ), which can corresponding rotate the rotatable couplingcollar 9500 back toward the initial orientation thereof.

In various embodiments, the rotatable coupling collar 9500 can be biasedinto the initial orientation relative to the elongated shaft assembly9116 and/or the distal attachment portion 9032. For example, a spring9514 can bias the coupling collar 9500 into the initial orientation. Thespring 9514 can include a proximal end 9516 that can be secured relativeto the elongated shaft assembly 9116, and a distal end 9550 that can besecured relative to the coupling collar 9500. For example, the proximalend 9516 of the spring 9514 can be retained in a proximal spring slot9556 (FIG. 119 ) of the shaft assembly 9116, and the distal end 9550 ofthe spring 9514 can be retained in a distal spring slot 9552 (FIG. 114 )of the rotatable coupling collar 9500, for example. In such embodiments,rotation of the coupling collar 9500 can displace the distal end 9550 ofthe spring 9514 relative to the proximal end 9516 of the spring 9514,which can generate a torsional force. Accordingly, the coupling collar9500 can resist rotation from the initial orientation to the secondaryorientation, and, when the coupling collar is rotated to the secondaryorientation, the spring 9514 can bias the coupling collar 9500 backtoward the initial orientation. Because the firing shaft rotator 9600 isengaged with the coupling collar 9500, the spring 9514 can also bias thefiring shaft 9104 toward the first orientation thereof.

In various embodiments, the rotatable coupling collar 9500 can include alocking detent 9518 that releasably locks the loading unit 9020 to theelongated shaft assembly 9116. Referring primarily to FIG. 114 , thelocking detent 9518 can extend radially inward from the inner perimeterof the rotatable coupling collar 9500. In various embodiments, thelocking detent 9518 can extend into a detent slot 9520 (FIG. 112 ) inthe distal attachment portion 9032. Referring primarily to FIG. 112 ,the detent slot 9520 can form a notch in the guide slot 9034. In variousembodiments, the detent slot 9520 can extend from the guide slot 9034,and can be perpendicular or substantially perpendicular to the guideslot 9034, for example. Further, the locking detent 9518 can move alongthe detent slot 9520 when the rotatable coupling collar 9500 rotatesbetween the initial orientation and the secondary orientation relativeto the elongated shaft assembly 9116.

In various embodiments, the locking detent 9518 can engage the distalattachment portion 9480 of the loading unit 9020 to lock the loadingunit 9020 relative to the elongated shaft assembly 9116. For example,referring again to FIG. 110 , the distal attachment portion 9480 caninclude the guide rail 9482, which can have a lock notch 9489 definedtherein. The lock notch 9489 can be structured and dimensioned toreceive the locking detent 9518 of the rotatable coupling collar 9500when the loading unit 9020 is fully inserted into the distal attachmentportion 9032. For example, when the distal attachment portion 9480 isfully inserted into the distal attachment portion 9032, the lock notch9489 of the distal attachment portion 9480 can be aligned with thedetent slot 9520 of the distal attachment portion 9032. Accordingly, thelocking detent 9518 can slide along the detent slot 9520 in the distalattachment portion 9032 and into the lock notch 9489 in the distalattachment portion. Furthermore, the locking detent 9518 can be biasedtoward engagement with the lock notch 9489 by the torsion spring 9514.For example, after the firing shaft rotator 9600 clears the distal end9490 of the rotation key 9486, the firing shaft 9104 can be biased backtoward the first orientation and the rotatable coupling collar 9500 canbe biased back toward the initial orientation by the torsion spring9514. Furthermore, when the coupling collar 9500 is rotated from thesecondary orientation back to the initial orientation, the lockingdetent 9518 thereof can be aligned and engaged with the lock notch 9489in the guide rail 9482.

In various embodiments, rotation of the coupling collar 9500 canfacilitate attachment and/or alignment of a firing assembly. Forexample, the firing shaft 9104 can extend between a proximal end 9524and a distal end 9522. The proximal end 9524 can have a rotation joint,which can permit rotation of the firing shaft 9104 between the firstconfiguration and the second configuration. Furthermore, the distal end9522 can have a coupler for attaching the proximal engagement member9467 of the drive beam assembly 9461 to the firing shaft 104. Rotationof the firing shaft 9104 can facilitate attachment of the proximalengagement member 9467. For example, as the coupler at the distal end9522 of the firing shaft 9104 rotates, the distal end 9522 is operablycoupled to the proximal engagement member 9467. In certain embodiments,the coupler can include a bayonet mount, which can engage acorresponding bayonet receiver of the cutting element in the loadingunit 9020. Referring primarily to FIGS. 108 and 109 , the firingassembly can further include a sleeve 9526 positioned around the firingshaft 9104 between the proximal end 9524 and the distal end 9522, forexample.

In various embodiments, when the firing shaft 9104 rotates within theelongated shaft assembly 9116, the firing shaft 9104 can rotate intoalignment with a firing shaft slot 528 in the loading unit 9020. Forexample, the firing shaft rotator 9600 can be aligned with the firingshaft slot 9528 when the loading unit 9020 is fully inserted andattached to the elongated shaft assembly 9116. However, in variousembodiments, when the loading unit 9020 is only partially inserted intothe elongated shaft assembly 9116, the firing shaft rotator 9600 can berotated, via the rotation key 9486, out of alignment with the firingshaft slot 9528. In other words, the firing shaft rotator 9600 can bealigned with the firing shaft slot 9482 when the firing shaft 9104 is inthe first orientation, and can be misaligned with the firing shaft slot9482 when the firing shaft 9104 rotates toward the second orientation.In such embodiments, when the loading unit is only partially insertedinto the elongated shaft assembly 9116 and/or before the loading unit9020 is releasably locked to the elongated shaft assembly 9116 by therotatable coupling collar 9500, the firing path of the firing shaftrotator 9600 can be blocked by the distal attachment portion 9480.Integration of the firing shaft 9104 and the coupling collar 9500 canensure the loading unit 9020 is securely attached to the elongated shaftassembly 9116 before the firing shaft 9104 can fire and/or advance. Forexample, the surgical instrument may be unable to fire until the cuttingelement in the loading unit 9020 is coupled to the firing shaft 9104,and/or until the firing shaft 9104 is properly aligned within theelongated shaft assembly 9116, for example.

In certain embodiments, rotation of the coupling collar 9500 canfacilitate attachment and/or alignment of an articulation assembly 9530.Referring primarily to FIGS. 108 and 109 , the articulation assembly9530 can include a proximal articulation bar 9538, a distal articulationbar 9420, and an articulation connector 9532. Furthermore, the shaftassembly 9116 can include a proximal articulation bar slot 9534, and theloading unit 9020 can include a distal articulation bar slot 9410, forexample. In certain embodiments, the proximal articulation bar 9538 canbe aligned with the proximal articulation bar slot 9534, and the distalarticulation bar 9420 can be aligned with the distal articulation barslot 10410. Referring now to FIG. 114 , the articulation connector 9532can be housed in the rotatable coupling collar 9500. For example, therotatable coupling collar 9500 can include an articulation connectorslot 9536, and the articulation connector 9532 can be moveablypositioned therein.

In various embodiments, referring again to FIGS. 108 and 109 , theproximal articulation bar 9538 can have a proximal notch 9540, and thedistal articulation bar 9420 can have a distal notch 9423. Furthermore,the articulation connector 9532 can include a proximal articulation lug9533 and a distal articulation lug 9535. The proximal articulation lug9533 can be retained in the proximal notch 9540 of the proximalarticulation bar 9538. In certain embodiments, the distal articulationlug 9535 can operably engage the distal notch 9423 of the distalarticulation bar 9420. As described herein, the rotatable couplingcollar 9500 can rotate between the initial configuration and thesecondary configuration. As the coupling collar 9500 rotates, thearticulation connector 9532 housed therein can also rotate relative tothe longitudinal axis defined by the shaft assembly 9116. In variousembodiments, the proximal articulation lug 9533 of the articulationconnector 9532 can remain positioned in the proximal notch 9540 of theproximal articulation bar 9538 as the articulation connector 9532rotates. Furthermore, the distal articulation lug 9535 of thearticulation connector 9532 can move into engagement with the distalnotch 9423 of the distal articulation bar 9420 as the articulationconnector 9532 rotates with the coupling collar 9500 from the secondaryorientation toward the initial orientation. For example, when theloading unit 9020 is fully inserted into the shaft 9488, the distalnotch 9423 of the distal articulation bar 9420 can be aligned with thedistal articulation lug 9535 of the articulation connector 9532. In suchembodiments, when the rotatable collar 9500 rotates back to the initialconfiguration, the distal articulation lug 9535 can slide into thedistal notch 9423 of the distal articulation bar 9420. When the distalarticulation lug 9535 is positioned in the distal notch 9423, thearticulation assembly 9530 can be fully assembled.

Referring primarily to FIG. 113 , in various embodiments, the proximalarticulation bar slot 9534 can include a first clearance 9542 and asecond clearance 9544. The proximal and distal articulation lugs 9533,9535 of the articulation connector 9532 can extend into the first andsecond clearances 942, 9544, respectively. In certain embodiments, thefirst and second clearances 9542, 9544 can provide a space for theproximal and distal articulation lugs 9533, 9535 to move as the collar9500 rotates and/or as the articulation assembly 9530 articulates, forexample.

Referring now to FIGS. 119-126 , to connect the loading unit to theelongated shaft assembly 9116 of the surgical instrument, a user canalign the alignment indicia 9484 of the loading unit 9020 with thealignment indicia 9502 of the elongated shaft assembly 9116 and/or thecoupling collar 9500 (FIG. 119 ). While maintaining alignment of thealignment indicia 9484, 9502, the user can move the loading unit 9020relative to the elongated shaft assembly 9116 along the longitudinalaxis LA-LA. The user can move the loading unit 9020 along a straight orsubstantially straight path, and, in various embodiments, need notrotate the loading unit 9020 relative to the elongated shaft assembly9116, for example. Referring primarily to FIG. 121 , the loading unit9020 can continue to translate relative to the elongated shaft assembly9116, and the guide rail 9482 of the distal attachment portion 9480 canfit into the guide slot 9034 (FIG. 112 ) in the distal attachmentportion 9032 of the elongated shaft assembly 9116. As the distalattachment portion 9480 moves into the distal attachment portion 9032,the guide slot 9034 can guide the guide rail 9482, and can maintainalignment of the alignment indicia 9484, 9502, for example. In otherwords, the guide slot 9034 and the guide rail 9482 can prevent rotationof the loading unit 9020 relative to the longitudinal axis of theelongated shaft assembly 9116. Referring primarily to FIG. 120 , theproximal articulation lug 9533 of the articulation connector 9532 canextend into the first clearance 9542 and can be positioned in theproximal notch 9540 of the proximal articulation bar 9420, and thedistal articulation lug 9535 of the articulation connector 9532 canextend through the second clearance 9544, for example.

Referring primarily to FIG. 122 , as the distal attachment portion 9480is inserted into the distal attachment portion 9032, the rotation keyramp 9488 of the rotation key 9486 can abut the firing shaft rotator9600. The rotation key ramp 9488 can guide and/or direct the firingshaft rotator 9600 into the clearance notch 9512 extending from therotation key slot 9510. Furthermore, as the firing shaft rotator 9600moves into the clearance notch 9512, the firing shaft 9104 can rotate inthe direction B. The firing shaft 9104 can rotate from the firstorientation to the second orientation. Such rotation of the firing shaft9104 can facilitate attachment of the distal end 9522 of the firingshaft 9104 with the proximal engagement member 9467 that is pivotallycoupled to the drive beam assembly 9461. Furthermore, rotation of thefiring shaft rotator 9600 can rotate the coupling collar 9500 in thedirection B via the engagement between the firing shaft rotator 9600 andthe firing shaft rotator groove 9600 in the coupling collar 9500. Thecoupling collar 9500 can rotate from the initial orientation to thesecondary orientation, for example. Additionally, the locking detent9518 can move along the detent slot 9520 in the shaft assembly 9116 asthe coupling collar 9500 rotates. Additionally, rotation of the couplingcollar 9500 can rotate the distal end 9550 of the spring 9514 becausethe distal end 9550 of the spring 9514 can be retained in the distalspring slot 9552 (FIG. 114 ) in the coupling collar 9500. Displacementof the distal end 9550 relative to the proximal end 9516 can generate atorsional springback force, which can bias the coupling collar 9500 fromthe secondary orientation toward the initial orientation, for example,and can bias the firing shaft 9104 from the second orientation towardthe first orientation, for example.

Referring primarily to FIG. 123 , as the coupling collar 9500 rotatestoward the secondary orientation, the proximal articulation lug 9533 canremain engaged with the proximal notch 9540 in the proximal articulationbar 9538. Furthermore, the distal articulation lug 9535 can rotate suchthat the distal articulation lug 9535 provides a clearance for thedistal articulation bar 9420 of the loading unit 9020. Referring to FIG.124 , the loading unit 9020 can be fully inserted into the elongatedshaft assembly 9116 when the coupling collar 9500 and the articulationconnector 9532 positioned therein are rotated to the secondaryorientation. In various embodiments, the distal articulation bar 9420can clear the distal articulation lug 9535 of the articulation connector9532 when the articulation connector 9532 is rotated to the secondaryorientation. Furthermore, the distal articulation lug 9535 can berotatably aligned with the distal notch 9423 in the articulationconnector 9532. Referring still to FIG. 124 , when the loading unit 9020is fully inserted into the elongated shaft assembly 9116, the firing rodrotator 9600 can clear the distal end 9490 of the rotation key 9486.

Referring now to the FIG. 125 , the firing shaft rotator 9600 can rotatein the direction C when the distal end 9490 of the rotation key 9486passes the firing shaft rotator 9600. For example, the firing shaftrotator 9600 can rotate in direction C from the second orientationtoward the first orientation. Furthermore, rotation of the firing shaftrotator 9600 can affect rotation of the coupling collar 9500 in thedirection C from the secondary orientation toward the initialorientation. In various embodiments, the spring 9514 can bias the firingrod 9104 toward the first orientation thereof and the collar 9500 towardthe initial orientation thereof. For example, the firing shaft rotator9600 can be positioned in the firing shaft rotator groove 9602 (FIG. 114) in the coupling collar 9500 such that rotation of the firing shaftrotator 9600 rotates the coupling collar 9500. Due to the alignment ofthe distal articulation lug 9535 of the articulation connector 9532 andthe distal notch 9423 of the distal articulation bar 9420, thearticulation connector 9532 can rotate as the coupling collar 9500rotates, and the distal articulation lug 9535 can rotate into engagementwith the distal notch 9423. The articulation assembly 9530 can beassembled when the distal articulation lug 9535 engages the distal notch9423. Furthermore, as the firing shaft rotator 9600 rotates in directionC, the distal end 9522 of the firing shaft 9104 can rotate in directionC, which can facilitate attachment of a the proximal engagement member9467 of the drive beam assembly 9461 to the distal end 9522 of thefiring shaft 9104.

Referring now to FIG. 126 , rotation of the coupling collar 9500 canalso rotate the locking detent 9518 of the collar 9500 into the locknotch 9489 in the guide rail 9482 of the distal attachment portion 9480.For example, when the loading unit 9020 is fully inserted into theelongated shaft assembly 9116, the lock notch 9489 can be aligned withthe detent slot 9520 such that the locking detent 9518 can rotatethrough the detent slot 9520 and into the lock notch 9489. As describedherein, the spring 9514 can bias the coupling collar 9500 to rotate inthe direction C (FIG. 125 ) after the firing shaft rotator 9600 clearsthe distal end 9490 of the rotation key 9486. Referring still to FIG.126 , when the firing shaft rotator 9600 rotates in direction C, thefiring shaft rotator 9600 can move into alignment with the firing shaftslot 9528 in the loading unit 9020. Alignment of the firing shaftrotator 9600 with the firing shaft slot 9528 can permit the firing shaft9104 to be advanced distally to fire the loading unit 9020, for example.

As described herein, the rotatable coupling collar 9500 can releasablylock the loading unit 9020 relative to the elongated shaft assembly9116. Furthermore, rotation of the coupling collar 9500 can facilitatesimultaneous attachment and/or alignment of the articulation assembly9530, as well as attachment and/or alignment of the firing shaft 9104with a cutting head assembly in the loading unit 9020, for example.Furthermore, rotation of the coupling collar 9500 can alsosimultaneously unlock the loading unit 9020 from the elongated shaftassembly 9116, disconnect the articulation assembly 9530, and/ordisconnect the firing shaft 104 from the cutting element in the loadingunit 9020. For example, when the coupling collar 9500 is again rotatedfrom the initial orientation toward the secondary orientation, thelocking detent 9518 can disengage the lock notch 9489 in the distalattachment portion 9480. Accordingly, the distal attachment portion 9480can be withdrawn from the distal attachment portion 9032 along thelongitudinal axis defined by the elongated shaft assembly 9116, forexample. In various embodiments, the loading unit 9020 can be unattachedfrom the elongated shaft assembly 9116 without rotating the loading unit9020 relative to the elongated shaft assembly 9116. However, thecoupling collar 9500 can rotate relative to the elongated shaft assembly9116, which can disconnect the distal articulation bar 9420 from thearticulation connector 9532 in the coupling collar 9500, and candisconnect the firing shaft 9104 from the cutting element or drive beamassembly in the loading unit 9020, for example.

Thus, as can be appreciated from the foregoing, at least one surgicalinstrument embodiment of the present invention includes a surgical endeffector that comprises a lower jaw and an upper jaw. In oneimplementation, the upper jaw comprises a proximal upper jaw portionthat is pivotally coupled to the lower jaw for selective pivotal travelrelative thereto about a pivot axis between open and closed positionsupon application of closing and opening motions to the proximal upperjaw portion. A distal upper jaw portion may be movably coupled to theproximal upper jaw portion and is supported for parallel movement towardand away from the lower jaw when the proximal upper jaw portion is inthe closed position. A firing member may be operably supported foroperable travel within the surgical end effector relative to the upperand lower jaws when the proximal upper jaw portion is in the closedposition and firing motions are applied to the firing member.

In at least one implementation, the surgical instrument may employ alockout system that is configured to not only prevent actuation of thefiring system or stated another way, advancement of the cutting headthrough the elongated channel when a cartridge is not present, but alsoto prevent such firing system actuation unless a new cartridge has beenproperly supported within the elongated channel. In suchimplementations, each new cartridge has a sled assembly supported in astarting position. When a cartridge has been properly installed withinthe elongated channel, the sled assembly interfaces with the lockoutsystem to thereby enable the cutting head to be advanced distallythrough the cartridge. If, however, a spent cartridge has beeninadvertently installed in the elongated channel, the lockout systemwill prevent actuation of the cutting head, because the sled assemblywill be located in the distal end of the cartridge and thereby unable tointerface with the lockout system. Such system will prevent re-actuationof the firing system, should the clinician fail to replace a spentcartridge and attempt to actuate the firing system.

In at least one other implementation, there is provided a surgicalinstrument that comprises an elongated shaft assembly and a surgical endeffector that includes an elongated channel that is coupled to theelongated shaft assembly. A surgical staple cartridge may be operablysupported in the elongated channel. The end effector may furthercomprise an anvil assembly that includes a proximal anvil portion thatis pivotally coupled to the elongated channel about a pivot axis. Theproximal anvil portion is selectively movable between open and closedpositions upon application of closing and opening motions thereto. Theanvil assembly may further comprise a distal anvil portion that isslidably coupled to the proximal anvil portion such that when theproximal anvil portion is in the closed position, the distal anvilportion is movable relative thereto while remaining parallel to theelongated channel. A firing member may be operably supported foroperable movement within the surgical end effector upon application offiring and retraction motions thereto. A firing system may be configuredto selectively apply the firing and retraction motions to the firingmember. The instrument may further include a closure system for applyingthe opening and closing motions to the proximal anvil portion.

In accordance with at least one other general form, there is provided asurgical method for treating target tissue within a patient. In variousimplementations, the method may comprise installing a hollow trocar portinto a patient and providing a surgical end effector. The surgical endeffector may comprise an elongated shaft assembly that defines alongitudinal tool axis and includes a lower jaw that is operably coupledto the elongated shaft assembly. The lower jaw may include elasticbiasing means. An upper jaw may be supported for movement relative tothe lower jaw upon application of actuation motions thereto. The upperjaw may be movable between a first insertion position wherein the upperjaw is compressible against the biasing means on the lower jaw toprovide the surgical end effector with a smallest cross-sectional shapeto facilitate passage of the surgical end effector through the hollowtrocar port into the patient and a primary opened position. When in theprimary open position the upper jaw may be movable into a fully openposition for admitting target tissue between the upper and lower jaws.Upon application of another actuation motion to the upper jaw, the upperjaw may be moved to a fully clamped position wherein a target tissue maybe clamped between the upper and lower jaws. A firing member may beoperably supported for selective operable travel within the surgical endeffector upon application of a firing motion thereto. The surgicalmethod may further comprise inserting the surgical end effector into thehollow trocar port such that an inner surface of the hollow trocar portcompresses the upper jaw into the insertion position until the surgicalend effector has exited the distal end of the trocar port whereupon thebiasing means moves the upper jaw into the primary opened position. Themethod may also comprise applying the actuation motion to the upper jawto move the upper jaw to the fully opened position and manipulating theend effector such that the target tissue is positioned between the upperand lower jaws. The method may further include applying the anotheractuation motion to the upper jaw to move the upper jaw into the fullyclamped position and applying the firing motion to the firing member tocause the firing member to travel from a starting position to an endingposition within the end effector.

In accordance with another general form, there may be provided asurgical method for treating target tissue within a patient. In variousimplementations, the method may comprise installing a hollow trocar portinto a patient and providing a surgical end effector. The surgical endeffector may comprise an elongated shaft assembly that has a lower jawoperably coupled thereto. The lower jaw may include elastic biasingmeans. An upper jaw may be supported for movement relative to the lowerjaw upon application of actuation motions thereto. The upper jaw may bemovable between a first insertion position wherein the upper jaw iscompressible against the elastic biasing means to provide the surgicalend effector with a smallest cross-sectional shape to facilitate passageof the surgical end effector through the trocar port into the patientand a primary opened position. When in the primary opened position, anapplication of an actuation motion to the upper jaw may move the upperjaw into a fully open position for admitting target tissue between theupper and lower jaws. Upon application of another actuation motion tothe upper jaw may move the upper jaw to a fully clamped position whereinthe target tissue is clamped between the upper and lower jaws. A controlinsert may operably support a portion of the upper jaw therein and beselectively movably supported in the lower jaw for travel between afirst position corresponding to the insertion position and a secondposition corresponding to the primary opened position. The surgical endeffector may further comprise means for moving the control insertbetween the first and second positions and a firing member that isoperably supported for selective operable travel within the surgical endeffector upon application of a firing motion thereto. The surgicalmethod may further comprise moving the control insert into the firstposition and inserting the surgical end effector through the hollowtrocar port into the patient. The method may also comprise moving thecontrol insert to the second position to enable the biasing means tomove the upper jaw into the primary opened position and applying theactuation motion to the upper jaw to move the upper jaw to the fullyopened position. The surgical method may also include manipulating theend effector such that the target tissue is positioned between the upperand lower jaws and applying another actuation motion to the upper jaw tomove the upper jaw into the fully clamped position. The surgical methodmay include applying the firing motion to the firing member to cause thefiring member to travel from a starting position to an ending positionwithin the end effector.

In accordance with another general form, there is provided a surgicalmethod for treating target tissue within a patient. In variousimplementations, the method comprises installing a hollow trocar portinto a patient and providing a surgical end effector. The surgical endeffector may comprise a lower jaw and an upper jaw that is supported formovement relative to the lower jaw between a first insertion positionwherein the upper jaw is compressible against the lower jaw to providethe surgical end effector with a smallest cross-sectional shape tofacilitate passage of the surgical end effector through the hollowtrocar port into the patient and a primary opened position. When in theprimary opened position, upon application of an actuation motion to theupper jaw, the upper jaw may be movable into a fully open position foradmitting target tissue between the upper and lower jaws. Uponapplication of another actuation motion to the upper jaw, the upper jawmay be moved to a fully clamped position wherein the target tissue isclamped between the upper and lower jaws. A firing member may beoperably supported for selective operable travel within the surgical endeffector upon application of a firing motion thereto. The surgicalmethod may further comprise operably coupling an elongated shaftassembly to the surgical end effector wherein the elongated shaftassembly defines a longitudinal tool axis and includes a distal closuretube portion that is supported for axial travel relative to the upperjaw to apply the actuation motions thereto. The distal closure tubeportion may include biasing means to automatically bias the upper jaw tothe primary opened position upon exiting of the upper jaw from thetrocar port. The surgical method may also include inserting the surgicalend effector into the hollow trocar port such that an inner surface ofthe hollow trocar port compresses the upper jaw into the insertionposition until the surgical end effector has exited the distal end ofthe trocar port whereupon the biasing means moves the upper jaw into theprimary opened position. The surgical method may also comprise applyingthe actuation motion to the upper jaw to move the upper jaw to the fullyopened position and manipulating the end effector such that the targettissue is positioned between the upper and lower jaws. The surgicalmethod may also include applying the another actuation motion to theupper jaw to move the upper jaw into the fully clamped position andapplying the firing motion to the firing member to cause the firingmember to travel from a starting position to an ending position withinthe end effector.

Referring to an exemplary embodiment depicted in FIGS. 127-129 , asurgical instrument 100 can include a handle assembly 104, a shaft 114extending from the handle assembly 104, and an end effector 120extending from the shaft 114. Referring primarily to FIG. 129 , a staplecartridge 140 can be loaded into an elongate channel 122 of a first jaw123 of the end effector 120. In certain embodiments, the staplecartridge 140 can be disposable and/or replaceable, for example.Additionally or alternatively, the staple cartridge 140 can beintegrated into the end effector 120, for example, and/or the endeffector 120 can be disposable and/or replaceable, for example. Invarious embodiments, the surgical instrument 100 can be motor-driven.For example, referring primarily to FIG. 128 , a motor 106 can bepositioned in the handle assembly 104. The handle assembly 104 of thesurgical instrument 100 can also include a trigger 108. Actuation of thetrigger 108 can affect closure of the jaws 123, 124 of the end effector120, firing of staples 160 from the staple cartridge 140, and/ortranslation of a firing bar 156 and cutting element 158 through the endeffector 120, for example.

Referring primarily to FIG. 129 , staples 160 can be ejectablypositioned in the staple cartridge 140. For example, at least one sled190 can translate through the staple cartridge 140 to eject the staples160 from the staple cartridge 140. The firing bar 156 having the cuttingelement or knife 158 can also translate through the staple cartridge 140to cut tissue captured between the end effector jaws, 123, 124, forexample. As depicted in FIG. 129 , the firing bar 156 and cuttingelement 158 can move from a proximal position in the first jaw 123 to adistal position in the first jaw 123. In various embodiments, tissuepositioned intermediate the staple cartridge 140 and the anvil 124 canbe stapled by the staples 160, and then cut by the cutting element 158,for example. Referring primarily to FIGS. 130 and 131 , the staplecartridge 140 can include a cartridge body 142 and staple cavities 144defined in the cartridge body 142. Staples, such as staples 160, forexample, can be removably positioned in the staple cavities 144. Incertain embodiments, each staple cavity 144 can removably store a singlestaple 160. Each staple cavity 144 can have a proximal end 146 and adistal end 148, for example, and longitudinal sidewalls 150 can extendbetween the proximal end 146 and the distal end 148 of each staplecavity 144. As described in greater detail herein, the proximal ends146, the distal ends 148, and/or the longitudinal sidewalls 150 of thestaple cavity 144 can guide and/or support the staple 160 duringdeployment from the staple cavity 144.

Referring now to FIGS. 132-139 , the staple 160 can include a base 162,a first staple leg 164 extending from the base 162, and a second stapleleg 166 extending from the base 162. The base 162 can have a proximalportion 168 and a distal portion 170, for example, and an intermediateportion 172 of the base 162 can be positioned between the proximalportion 168 and the distal portion 170, for example. As depicted inFIGS. 132-139 , the first staple leg 164 can extend from the proximalportion 168 of the base 162, and the second staple leg 166 can extendfrom the distal portion 170 of the base 162. The staple legs 164, 166can include a tip 174, for example, which can have a pointed orsubstantially pointed end. In various embodiments, the tip 174 canfacilitate piercing into and/or through tissue, for example. In certainembodiments, the staple legs 164, 166 can include corner edges 176,which can be sharp, or substantially sharp, for example, and can alsofacilitate piercing into and/or through tissue, for example. In otherembodiments, the staple legs 164, 166 can include rounded corner edges.

Referring still to FIGS. 132-139 , chamfers 184, 186 can be positionedbetween the staple legs 164, 166 and the base 162. For example, an upperchamfer 184 can extend between the staple legs 164, 166 and the base162, and/or a lower chamfer 186 can extend between the staple legs 164,166 and the base 162. When tissue is captured by the staple 160, thetissue can be compressed between the base 162 and the deformed staplelegs 164, 166, and the chamfers 184, 186 may contact the compressedtissue. In various embodiments, the chamfers 184, 186 can compress thecaptured tissue, for example, and may prevent the base 162 fromunintentionally piercing and/or cutting the captured tissue, forexample.

In various embodiments, the base 162 of the staple 160 may beasymmetrical relative to the staple legs 174, 176. For example,referring primarily to FIG. 136 , a first axis A may be defined betweenthe first and second staple legs 174, 176, and the base 162 can beasymmetrical relative to the first axis A. The base 162 can benon-linear, for example, and can include at least one laterallycontoured portion 178 that bends or curves away from the axis A. Thebase 162, or at least a portion of the base 162, can be defined by asecond axis B. The contoured portion 178 can be include straight and/orcurved regions, and may be generally non-parallel to the first axis Aand the second axis B, for example. For example, the contoured portion178 can bend or curve away from the first axis A, include a straight orsubstantially straight portion, and bend or curve toward the second axisB (FIG. 136 ).

Referring still to FIG. 136 , the center of mass (COM) of the staple 160can be offset from the first axis A. In various embodiments, a portionof the base 162 can extend along the second axis B, for example, whichcan be parallel or substantially parallel to the first axis A. Forexample, the intermediate portion 172 of the base 162 can be parallel orsubstantially parallel to the first axis A. A contoured portion 178 canbe positioned between the proximal portion 168 and the intermediateportion 172, for example, and another contoured portion 178 can bepositioned between the distal portion 170 and the intermediate portion172, for example. The contoured portions 178 can laterally offset theintermediate portion 172 of the base 162 from the staple legs 164, 166and from the first axis A, for example. In certain embodiments, thestaple legs 164, 166 can be positioned in a first plane defined by thefirst axis A, for example, and the intermediate portion 172 of the base162 can be positioned in a second plane defined by the second axis B.The second plane can be parallel, or substantially parallel, to thefirst plane, for example, and the center of mass (COM) of the staple 160can be positioned between the first plane and the second plane. In suchembodiments, the staple 160 can include a leg formation plane, e.g., theplane defined by the first axis A, which can be offset from the COM ofthe staple 160. For example, deformation of the staple 160 can form amodified “B-form”, for example, and the staple legs 164, 166 may benon-coplanar and/or laterally offset from the intermediate portion 172of the staple base 162. In various instances, the modified “B-form”staple formation can engage, capture, compress, and/or affect a greatervolume of tissue, for example. Additionally, in certain instances, themodified “B-form” staple formation can exert forces on the engagedtissue in different and/or divergent directions, for example. Modified“B-form” can define a tissue entrapment area extending in threedifferent directions. For instance, a portion of the tissue entrapmentarea can be defined in two directions by the legs 164 and 166 andanother portion of the tissue entrapment area can be defined in a thirddirection between the base 162 and the legs 164, 166.

In various embodiments, the intermediate portion 172 of the staple base162 can include a longitudinal guide surface 173. For example, asdescribed in greater detail herein, the longitudinal guide surface 173can slide and/or move against a guide surface 150 in the staple cavity144 (FIGS. 130 and 131 ) as the staple 160 is fired and/or ejected fromthe cartridge body 142 (FIGS. 130 and 131 ), for example. In suchembodiments, the longitudinal guide surface 173 can balance and/orstabilize the staple 160 during deployment. Furthermore, theintermediate portion 172 of the staple base 162 can include atissue-contacting surface 175 (FIG. 135 ), which can be flat orsubstantially flat, for example. In various instances, thetissue-contacting surface 175 of the base 162 can form a flat surfacefor contacting captured tissue, which can provide a broad and/or smoothsurface for applying and/or distributing pressure on the captured and/orcompressed tissue. In such embodiments, tissue tearing and/or traumawithin the staple 160 may be reduced and/or minimized, for example.

In various embodiments, the base 162 of the staple 160 can include oneof more drive surfaces. For example, the base 162 can include an initialdrive surface 180 and a secondary drive surface 182. Referring still toFIGS. 132-139 , the proximal portion 168 of the base 162 can include theinitial drive surface 180, for example, and/or the intermediate portion172 of the base 172 can include the secondary drive surface 182. Forexample, the proximal portion 168 can include a nub having the firstdrive surface 180. The nub of the first drive surface 180 can include arounded and/or sloped surface, for example. The secondary drive surface182 can comprise a ramp on the intermediate portion 172 of the base 162.For example, the secondary drive surface 182 can be positioned distal tothe initial drive surface 180 and/or between the proximal portion 168and the distal portion 170 of the base 162, for example. The secondarydrive surface 182 can include an inclined surface or plane, for example,and can slope downward in the direction of the distal portion 170 (seeFIGS. 133 and 134 ).

Referring primarily to FIGS. 133 and 134 , a staple midline M can bedefined intermediate the first staple leg 164 and the second staple leg166. The staple midline M can bisect the staple 160, and can passthrough the center of mass (COM) of the staple 160, for example. Invarious embodiments, the secondary drive surface 182 can extend acrossthe midline M. For example, the secondary drive surface 182 can extendalong the intermediate portion 172 of the base 162, and can cross from aproximal side of the midline M to a distal side of the midline M. Insuch embodiments, during deployment of the staple 160 via the sled 190,as described in greater detail herein, a ramp 192 of the sled 190 candrive the staple 160 at and/or near the midline M of the staple 160during a portion of the staple's deployment. In various embodiments, thedistal end of the secondary drive surface 182 can also include a stapleoverdrive 188, which is described in greater detail herein. Referringprimarily to FIG. 133 , the staple overdrive 188 can include the lowestpoint of the intermediate portion 172 of the base 162 and, in someembodiments, can be vertically aligned with the lowest point of theproximal portion 168 and/or the distal portion 170 of the base 162, forexample. In other embodiments, the staple overdrive 188 may bepositioned vertically below or above the lowest portion of the proximalportion 168 and/or the distal portion 170 of the base 162.

In various embodiments, the drive surfaces 180, 182 of the staple 160can be separate and distinct. For example, the drive surfaces 180, 182can be laterally and/or longitudinally offset, such that the drivesurfaces 180, 182 are unconnected and/or nonadjacent. Each drive surfacecan be discrete, for example. The initial drive surface 180 can overlapa first plane (see axis A in FIG. 136 ), for example, and the secondarydrive surface 182 can overlap a second plane (see axis B in FIG. 136 ),for example. In certain embodiments, the drive surfaces 180, 182 can beparallel. For example, the initial drive surface 180 can extend alongthe first axis A (FIG. 136 ), and the secondary drive surface 180 canextend along the second axis B (FIG. 136 ). In various embodiments, alateral gap having a width x (FIGS. 136 and 137 ) can be defined betweenthe initial drive surface 180 and the secondary drive surface 182, forexample. In some embodiments, a longitudinal gap having a width y (FIG.136 ) can be defined between the initial drive surface 180 and thesecondary drive surface 182, for example. The initial drive surface 180can be proximal to the secondary drive surface 182, for example.Furthermore, a non-driven portion of the base, such as the lower chamfer186 of the contoured portion 178 between the proximal portion 168 andthe intermediate portion 172, for example, can separate the initialdrive surface 180 and the secondary drive surface 182, for example. Invarious embodiments, the contoured portions 178 can traverse between thefirst plane defined by axis A and the second plane defined by axis B,for example.

Referring still to FIGS. 132-139 , at least one of the drive surfaces180, 182 of the staple 160 can be integrally formed with the staple 160.For example, the drive surfaces 180, 182 can be defined in the base 162of the staple 160. The staple 160 can comprise a single, unitary piece,for example, which may integrally include the drive surfaces 180, 182.The drive surfaces 180, 182 can comprise a boundary or perimeter surfaceof the single, unitary piece, for example. In various circumstances, thestaple 160 can be seamless, for example, and many not include anyadhered and/or overmolded features, for example. Furthermore, the base162 and the staple legs 164, 166 can be a contiguous part, and the base162 can integrally define the drive surfaces 180, 182, for example. Incertain instances, as described in greater detail herein, the staple 160can be stamped or otherwise formed from a single piece of material, forexample, and can remain a single piece of material, for example. Invarious instances, the drive surfaces 180, 182 can comprise a surface orflat of the formed piece.

Referring now to FIGS. 140-143 , the sled 190 can drive the staples 160from the cavities 144 in the cartridge body 142 (FIG. 129 ). In variousinstances, the sled 190 can directly contact the staples 160 and/or candirectly drive the staples 160. For example, the sled 190 can include aramp or inclined surface 192, which can contact at least one drivesurface 180, 182 of the staple 160. As the sled 190 translates relativeto the staple 160, the ramp 192 can push the drive surfaces 180, 182 tolift the staples 160. In various embodiments, the degree of incline ofthe ramp 192 can vary along the length thereof. For example, the ramp192 can be designed to lift the staple 160 faster and/or slower duringat least part of the staple's deployment. Moreover, the degree ofincline of the ramp 192 can be designed and/or selected based on thedegree of incline of a staple drive surface 180, 182. For example, theramp 192 can define an incline that is greater than, less than, and/orequal to the incline of the initial drive surface 180 and/or thesecondary drive surface 182. The relationship between the ramp 192incline and the drive surface 180, 182 incline can affect the speed ofstaple deployment, for example.

Referring still to FIGS. 140-143 , the sled 190 can include at least onelateral portion 191 a, 191 b. For example, the sled 190 can include asingle lateral portion, a pair of lateral portions, and/or more than twolateral portions. In various instances, each lateral portion 191 a, 191b can correspond to a row of staples 160 removably positioned in thecartridge body 142. As further depicted in FIGS. 140-143 , the lateralportions 191 a, 191 b can be longitudinally staggered. For example, incertain embodiments, the first lateral portion 191 a can lag behind orfollow the second lateral portion 191 b by a length of distance L (FIGS.140 and 142 ). In other embodiments, the lateral portions 191 a, 191 bcan be longitudinally aligned and/or the second lateral portion 191 bcan lag or follow the first lateral portion 191 a, for example. Inembodiments where the sled 190 comprises multiple lateral portions 191a, 191 b, an intermediate portion 193 can connect and/or bridge thelateral portions 191 a, 191 b, for example.

Referring primarily to FIGS. 140-143 , the sled 190 can transfer betweenthe drive surfaces 180, 182 of the staple 160. Stated differently, thesled 190 can exert a driving force on the initial driving surface 180 ofthe staple 160, for example, and can then transition to exert a drivingforce on the second, or secondary, driving surface 182 of the staple160. In certain embodiments, the sled ramp 192 can include a leadingsurface 194 and a trailing surface 196. The leading surface 194 can beadjacent to and/or connected to the trailing surface 196, for example,and the staple 160 can smoothly transition between the leading surface194 and the trailing surface 196. For example, the leading surface 194can contact the staple 160 and begin to lift the staple 160, and thetrailing surface 196 can move into contact with the staple 160 andcontinue to lift the staple 160. In certain instances, the trailingsurface 196 can smoothly lift the staple 160 out of and/or away fromengagement with the leading surface 194, for example.

Referring still to FIGS. 140-143 , the leading surface 194 can bealigned with the initial drive surface 180 and the trailing surface 196can be aligned with the secondary drive surface 182, for example. Inoperation, the leading surface 194 of the ramp 192 can initially contactthe staple 160. For example, referring to FIGS. 140 and 141 , as thesled 190 translates, the leading surface 194 can contact the initialdrive surface 180 of the staple 160. The inclined leading surface 194can exert a driving force on the initial drive surface 180, which canbegin to the lift the base 162 of the staple 160. For example, thestaple 160 can be lifted a first distance or height by the leadingsurface 194. As the sled 190 continues to translate, referring now toFIGS. 142 and 143 , the trailing surface 196 can move into contactingengagement with the secondary drive surface 182 of the staple 160, forexample. The inclined trailing surface 196 can exert a driving force onthe secondary drive surface 182, for example, which can continue to thelift the base 162 of the staple 160. For example, the staple 160 can belifted a second distance or height by the trailing surface 194.

In various instances, the trailing surface 196 can lift the initialdrive surface 180 away from and/or out of contact with the leadingsurface 194 of the ramp 192, for example. For example, the trailingsurface 196 can contact the secondary drive surface 182 and immediatelylift the staple 160 such that the primary drive surface 180 is moved outof driving contact with the leading surface 194. In other embodiments,the leading surface 194 can drive the initial drive surface 180 and thetrailing surface 196 can drive the secondary drive surfacesimultaneously for at least a portion of the staple's deployment. As thesled 190 continues to translate, the trailing surface 196 can lift thebase 162 out of the staple cavity 144 (FIGS. 130 and 131 ) and/or caneject the staple 160 from the cartridge 140 (FIGS. 130 and 131 ). Forexample, the proximal portion of the trailing surface 196 can include asled overdrive 198. In various embodiments, the sled overdrive 198 canextend out of the staple cavity 144 and can lift the staple overdrive188, i.e., the lowest portion of the intermediate portion 172 of thebase 162 (see FIG. 133 ), out of the staple cavity 144.

Deployment of multiple staples 160 according to an exemplary applicationof the present disclosure is depicted in FIGS. 144-147 . In certainembodiments, multiple rows of staple cavities 144 can be defined in thecartridge body 142. For example, multiple rows of staple cavities 144can be defined on a first side of the cartridge slot 143 (FIG. 129 ),and multiple rows of staple cavities 144 can be defined on a second sideof the cartridge slot 143. FIGS. 144-147 depict two rows of staples 160positioned in two rows of staples cavities 144 in the cartridge body142. Referring still to FIGS. 144-147 , the staples 160 a, 160 c, and160 e can be positioned in a more inner row of staple cavities 144, forexample, and the staples 160 b, 160 d, and 160 f can be positioned in amore outer row of staple cavities 144, for example. In variousembodiments, the first inner staple 160 a can be positioned nearer tothe cartridge slot 143 than the first outer staple 160 b. For example,the first inner staple 160 a can be adjacent to the cartridge slot 143,and the first outer staple 160 b can be intermediate the first innerstaple 160 a and the side of the cartridge body 142, for example. Invarious embodiments, additional rows of staples 160 can be defined inthe cartridge body 142. For example, at least one row of staples can bepositioned intermediate the first staple 160 a and the cartridge slot143, and/or at least one row of staples 160 can be positionedintermediate the first outer staple 160 b and the side of the cartridgebody 142, for example.

Referring primarily to FIG. 144 , as the sled 190 moves distally, thesecond lateral portion 191 b can contact the first inner staple 160 a.The leading surface 194 (FIGS. 140-143 ) of the second lateral portion191 b can begin to lift the first inner staple 160 a, for example.Referring now to FIG. 145 , as the sled 190 continues to move distally,the trailing surface 196 (FIGS. 140-143 ) of the second lateral portion191 b can continue to lift the first inner staple 160 a, and can movethe first inner staple 160 a into forming contact with the anvil 152 ofthe end effector 120, for example. Additionally, the leading surface 194of the second lateral portion 191 b can move into contact with thesecond inner staple 160 c, for example. In various instances, the firstlateral portion 191 a can move into contact with the first outer staple160 b at the same time that the second lateral portion 191 b moves intocontact with the second inner staple 160 c, for example. In certainembodiments, the longitudinal lag or offset between the first lateralportion 191 a and the second lateral portion 191 b can correspond to thelongitudinal distance between the first outer staple 160 b and thesecond inner staple 160 c. For example, the first lateral portion 191 acan lag behind the second lateral portion 191 b a length L (FIGS. 140and 142 ), and the first outer staple 160 b can be longitudinally offsetfrom the second inner staple 160 c by the length L. In such embodiments,deployment of the first outer staple 160 b and the second inner staple160 c can be simultaneous and/or synchronized, for example.

Referring now to FIG. 146 , as the sled 190 continues to progress, thetrailing surface 196 of the second lateral portion 191 b can continue tolift the first inner staple 160 a toward the anvil 152. The stapleforming pockets 154 defined in the anvil 152 can catch the staple legs164, 166, and can deform the first inner staple 160 a. Furthermore, thesecond lateral portion 191 b can continue to lift the second innerstaple 160 c, and the first lateral portion 191 a can continue to liftthe first outer staple 160 b, for example. Referring now to FIG. 147 ,as the sled 190 continues to move distally, the second lateral portion191 b can eject the first inner staple 160 a from the staple cavity 144.In various instances, the sled overdrive 198 (FIGS. 140-143 ), can liftthe staple overdrive 188 to clear the staple base 162 over the cartridgebody 142, for example. As the staple forming pockets 154 of the anvil124 continue to form the first inner staple 160 a, the second lateralportion 191 b can continue to lift the second inner staple 160 c, forexample, and the first lateral portion 191 a can continue to lift thefirst outer staple 160 b. Additionally, the second lateral portion 191 bcan move into contact with the third inner staple 160 e, for example,and the first lateral portion 191 a can move into contact with thesecond outer staple 160 d, for example. In various instances, similar tothe above, the second outer staple 160 d can be longitudinally offsetfrom the third inner staple 160 e by the length L (FIGS. 140 and 142 ).

As described herein, the staples 160 can be sequentially fired from thecartridge 140. For example, as the sled 190 moves distally, the sled 190can sequentially fire staples 160 from a proximal portion of thecartridge body 142 toward a distal portion of the cartridge body 142. Asdescribed herein, the sled 190 can fire a first, more proximal, innerstaple 160 a before firing a second, more distal, inner staple 160 c. Inother embodiments, the sled 190 may translate proximally to fire staples160 from a staple cartridge. In such embodiments, the sled 190 cansequentially fire staples 160 from a distal portion of the staplecartridge 140 toward a proximal portion of the staple cartridge 140.Moreover, firing of the staples 160 from the staple cartridge 140 can bepaced or synchronized. For example, the first outer staple 160 b and thesecond inner staple 160 c can be fired simultaneously, and/or the secondouter staple 160 d and the third inner staple 160 e can be firedsimultaneously, for example. For example, the longitudinal offsetbetween the first lateral portion 191 a of the sled 190 and the secondlateral portion 191 b of the sled 190 can correspond to the longitudinaldistance between a staple 160 in a first row of staple cavities and astaple 160 in a second, different row of staple cavities. In suchembodiments, deployment of the staples 160 can be timed such that astaple 160 in the first row of staple cavities is fired at the same timeas a staple 160 in the second row of staple cavities. The timing orpacing of staple deployment can improve tissue positioning and/orplacement during firing. For example, sections of the tissue can be heldin position by the end effector jaws 123, 124 (FIG. 129 ), and thesections can be stapled simultaneously. In other instances though, theoffset between 191 a and 191 b may not be the same as the offset betweenthe staples in the staple rows.

An exemplary embodiment of staple deployment is further illustrated inFIGS. 148-157 . For example, the staples 160 a, 160 b, 160 c, and 160 dcan be positioned on both sides of the cartridge slot 140, and can beejectably positioned in staple cavities 144 defined in the cartridgebody 142. Referring primarily to FIGS. 148 and 149 , the staples 160 a,160 b, 160 c, and 160 d can be unfired, and the sleds 190 can bepositioned proximal to the cartridge body 142. The sleds 190 can bealigned with the rows of staple cavities 144 in the cartridge body 142.For example, a first sled 190 can be aligned with the staples 160 a, 160c in the first inner row of staple cavities 144 and with the staples 160b, 160 d in the first outer row of staple cavities 144, and a secondsled 190 can be aligned with the staples 160 a, 160 c in the secondinner row of staple cavities 144 and with the staples 160 b, 160 d inthe second outer row of staple cavities 144. The first lateral portions191 a of each sled 190 can be aligned with the outer staples 160 b, 160d, and the second lateral portions 191 b of each sled 190 can be alignedwith the inner staples 160 a, 160 c, for example.

Referring primarily to FIGS. 150 and 151 , the first inner staples 160 acan be moved or lifted to partially fired positions relative to thecartridge body 142. For example, the second lateral portions 191 b ofeach sled 190 can move into engagement with the first inner staples 160a. The leading surfaces 194 of the second lateral portions 191 b canlift the first inner staples 160 a a first distance. Subsequently, thetrailing surfaces 196 can move into engagement with the first innerstaples 160 a to further lift the first inner staples 160 a. In variousembodiments, distal translation of the sleds 190 can be coordinated, andthe first inner staples 160 a on each side of the slot 143 can be firedsimultaneously, for example. As the first inner staples 160 a arelifted, a portion of each staple 160 a can slide or move against alongitudinal guide surface 150 of the staple cavity 144, and thelongitudinal guide surface 150 can support and/or balance the torquegenerated by the sled 190, as described in greater detail herein.

Referring now to FIGS. 152 and 153 , as the sleds 190 continue totranslate relative to the cartridge 140, the sleds 190 can move intoengagement with the first outer staples 160 b and the second innerstaples 160 c. In various instances, the sleds 190 can contact the firstouter staples 160 b and the second inner staples 160 c simultaneously.For example, the first lateral portions 191 a of sleds 190 can contactthe first outer staples 160 b as the second lateral portions 191 b ofthe sleds 190 contact the second inner staples 160 c, for example.Referring primarily to FIG. 153 , the leading surfaces 194 of the firstlateral portions 191 a and the second lateral portions 191 b of thesleds 190 can engage the initial drive surfaces 180 of the staples 160b, 160 c, and can lift the staples 160 b, 160 c relative to thecartridge body 142. Additionally, the trailing surfaces 196 of thesecond lateral portions 191 b of the sleds 190 can continue to lift thefirst inner staples 160 a, for example. As the first inner staples 160 acontinue to move out of the staple cavities 144, an anvil 152 (FIGS.144-147 ) can begin to deform the first inner staples 160 a. Forexample, staple forming pockets 154 (FIGS. 144-147 ) can catch, turnand/or bend the legs 164, 166 of the first inner staples 160 a. Asdescribed herein, the anvil 152 can deform the staples 160 a intomodified “B-forms”, for example.

Referring now to FIGS. 154 and 155 , as the sleds 190 continue totranslate relative to the staple cartridge 140, the second lateralportions 191 b of the sleds 190 can continue to lift the first innerstaples 160 a, for example, and the anvil 152 (FIGS. 144-147 ) cancontinue to deform the first inner staples 160 a, for example. Invarious instances, the sleds 190 can also continue to lift the firstouter staples 160 b and the second inner staples 160 c. For example, thetrailing surfaces 196 of the sleds 190 can move into engagement with thesecondary drive surfaces 182 of the first outer staples 160 b and thesecond inner staples 160 c, and can lift the staple bases 162 upward,for example, such that the staples legs 164, 166 continue to move out ofthe cartridge body 142.

Referring now to FIGS. 156 and 157 , as the sleds 190 continue totranslate relative to the cartridge 140, the second lateral portions 191b of the sleds 190 can continue to simultaneously lift the first innerstaples 160 a. For example, the sled overdrives 198 (FIGS. 142 and 143), can lift the first inner staples 160 a entirely out of the cartridgebody 142, such that the first inner staples 160 a are entirely ejectedfrom the staple cartridge 140. In various instances, the anvil 152(FIGS. 144-147 ) can continue to deform the first inner staples 160 a,for example, and the first inner staples 160 a can be fully deformedwhen lifted entirely out of the cartridge body 142. Additionally, thetrailing surfaces 196 of the sleds 190 can also continue tosimultaneously lift the first outer staples 160 b and the second innerstaples 160 c. For example, the trailing surfaces 196 of the firstlateral portions 191 a can lift or drive the first outer staples 160 b,and the trailing surfaces 196 of the second lateral portions 191 b canlift or drive the second inner staples 160 c, for example. Moreover, asthe first outer staples 160 b and the second inner staples 160 ccontinue to move out of the staple cavities 144, the anvil 152 (FIGS.144-147 ) can begin to deform the first outer staples 160 b and thesecond inner staples 160 c. For example, staple forming pockets 154(FIGS. 144-147 ) can catch, turn and/or bend the legs 164, 166 of thefirst outer staples 160 b and the second inner staples 160 c. In variousinstances, the sleds 190 can continue to translate relative to thecartridge body 142, and the first and second lateral portions 191 a, 191b of the sleds 190 can continue to pace and/or time the deployment ofthe staples 160 from adjacent and/or neighboring staple rows. The sleds190 can sequentially fire staples 160 from the proximal portion of thestaple cartridge 140 to the distal portion of the staple cartridge 140.In other embodiments, the sleds 190 can move proximally, and can firestaples 160 from the distal portion of the staple cartridge 140 toward aproximal portion of the staple cartridge 140, for example. Moreover, incertain instances, the spacing between the staples and the lateral sledportions can affect non-synchronized deployment of the staples, forexample.

Referring now to FIGS. 182-190 , in various instances, the staple cavity144 can guide the staple 160 as the sled 190 moves the staple 160through a firing progression. For example, in various instances, theleading surface 194 of the sled 190 can contact the initial drivesurface 180 of the staple 160, and can exert a driving force D₁ (FIG.184 ) on the staple 160 via the initial drive surface 180 (FIGS. 182-184). The leading surface 194 can lift the staple 160 upward along a planedefined by axis E (FIG. 183 ) and axis F (FIG. 184 ). As indicated inFIGS. 183 and 184 , the staple's center of mass (COM) can be offset fromthe axes E and F and, in such embodiments, the driving force D₁ (FIG.184 ) exerted on the initial drive surface 180 in the plane defined byaxes E and F can generate a torque T₁ (FIG. 184 ). As described ingreater detail herein, the staple cavity 144 can include a longitudinalsidewall 150 between the proximal end 146 and the distal end 148 of thestaple cavity 144. In certain embodiments, the staple cavity 144 caninclude a first sidewall 150 a and a second sidewall 150 b. Moreover, asdescribed herein, the sidewalls 150 a, 150 b can resist torsion of thestaple 160 during firing. For example, when the leading surface 194 ofthe sled 190 drives the initial drive surface 180 of the staple 160along the plane defined by axes E and F, the second sidewall 150 b canresist the counterclockwise torque T₁ (FIG. 184 ) corresponding to thedriving force D₁ generated by the sled 190. As the staple 160 is lifteda first distance by the leading surface 194 of the sled 190, the secondsidewall 150 b can guide and support the intermediate portion 172 of thestaple base 162. For example, the flat surface 173 of the intermediateportion 172 of the staple base 162 can slide along and/or move againstthe second sidewall 150 b.

Referring now to FIGS. 185-187 , when the sled 190 transitions betweenthe initial drive surface 180 and the secondary drive surface 182, asdescribed herein, the trailing surface 196 of the sled 190 can exert adriving force D₂ (FIG. 187 ) on the staple 160 via the secondary drivesurface 182. In various instances, the trailing surface 196 of the sled190 can lift the base 162 of the staple 160 upward along a plane definedby axis I (FIG. 186 ) and axis J (FIG. 187 ). As indicated in FIGS. 186and 187 , the staple's center of mass (COM) can be offset from the planedefined by axes I and J and, in such embodiments, the driving force D₂(FIG. 187 ) exerted on the secondary drive surface 182 by the trailingsurface 196 of the sled 190 can generate a torque T₂ (FIG. 187 ). Uponcomparing FIGS. 184 and 187 , it can be seen that the driving force D₁is applied to the staple 160 on a first side of the COM and the drivingforce D₂ is applied on the opposite side of the COM. In variousinstances, the torque T₁ can be in a first direction, and the torque T₂can be in second direction, and the second direction can be opposite tothe first direction, for example. When the trailing surface 196 drivesthe secondary drive surface 182 of the staple 160 along the planedefined by axes I and J, the first sidewall 150 a can resist theclockwise torque T₂ (FIG. 187 ). As the staple 160 is lifted the seconddistance by the trailing surface 194, the first sidewall 150 a can guideand support the proximal and distal ends 168, 170 of the staple base162. For example, the proximal and distal ends 168, 170 of the base 162can slide along and/or move against the first sidewall 150 a.

The reader will appreciate that, in certain embodiments, various staplesand/or features thereof, which are described herein with respect to thestaple's COM, can be similarly applicable to the staple's center ofgeometry. In various instances, a staple, such as staple 160, forexample, can comprise a single material and/or can have a uniformcomposition. In such embodiments, the COM of the staple can correspondto the center of geometry of the staple. In other embodiments, a staplecan comprise multiple materials and/or a non-uniform composition. Forexample, the staple can be formed from multiple pieces and/or materialsthat have been welded and/or otherwise joined together. In certainembodiments, multiple sheets of at least two different materials can bewelded together, for example, and the staple can be cut from a portionof the welded sheet comprising more than one material. In otherembodiments, multiple sheets of at least two different materials can belayered, rolled and/or sealed together, for example, and the staple canbe cut from a portion of the sheet comprising more than one material. Insuch embodiments, the COM of the staple can be offset from the center ofgeometry of the staple. For example, the COM of the staple can belaterally and/or longitudinally offset from the staple's center ofgeometry.

As depicted in FIGS. 184 and 187 , the sled 190 can exert a verticaldriving force D₁, D₂ on the staple 160 during deployment. The readerwill appreciate that a driving force generated by the sled 190 can alsocomprise a horizontal component. In various embodiments, the proximaland/or distal ends 146, 148 of the staple cavity 144 can guide andsupport the staple legs 164, 166, as the staple 160 is lifted by thesled 190. In various embodiments, the proximal and/or distal ends 146,148 of the staple cavity 144 can balance the torque generated by thehorizontal component of the driving force. For example, as the sled 190moves distally, the distal end 148 of the staple cavity 144 can resistrotation and/or torqueing of the staple 160 during deployment. Referringnow to FIGS. 188-190 , the trailing surface 196 can continue to lift thestaple 160 out of the staple cavity 144. For example, the sled overdrive198 can contact the staple overdrive 188 to lift the base 162 of thestaple 160 out of the cartridge body 140.

Referring now to FIGS. 171-173 , a staple cartridge, such as a staplecartridge 240, for example, can be loaded into the elongate channel 122of the end effector 120 (FIG. 129 ). Staples, such as staples 160, forexample, can be ejectably positioned in the staple cartridge 240. Forexample, sleds 190 (FIGS. 140-143 ) can translate through the staplecartridge 240 to eject the staples 160 therefrom. In various instances,the staple cartridge 240 can include a cartridge body 242 and cavities244 defined in the cartridge body 242. Staples 160 can be removablypositioned in the staple cavities 244, for example. For example, eachstaple cavity 244 can removably store a single staple 160. Moreover,each staple cavity 244 can have a proximal end 246 and a distal end 248,for example, and longitudinal sidewalls 250 can extend between theproximal end 246 and the distal end 248 of each staple cavity 244.Similar to the cavities 144 described herein, the proximal ends 246,distal ends 248, and/or longitudinal sidewalls 250 can guide and/orsupport the staples 160 during firing. For example, the longitudinalsidewalls 250 can counterbalance the torque exerted on the staple 160 bythe translating sled 190. In various instances, the cavities 244 canalso include diagonal guide surfaces 251 between the sidewalls 250. Forexample, a proximal diagonal guide surface 251 a can extend between theproximal end 246 of the cavity 244 and a sidewall 250 of the cavity 244.Additionally or alternatively, a distal diagonal guide surface 251 b canextend between the distal end 248 of the cavity 244 and a sidewall 250of the cavity 244. The diagonal guide surfaces 251 a, 251 b can guideand/or support the contoured portions 178 (FIGS. 132-139 ) of the staple160, for example, as the staple 160 is lifted within the staple cavity244. For example, a portion of the contoured portion 178 can slide alongand/or move against the diagonal guide surfaces 251 a, 251 b. In such anarrangement, the diagonal guide surfaces 251 a, 251 b can balance thetorque exerted on the staple 160, for example.

Referring now to FIGS. 158A-158C, staples, such as the staples 160, forexample, can be cut, formed and/or stamped from a sheet of material,such as a sheet of material 130, for example. The sheet of material 130can be metallic, for example, and can comprise stainless steel and/ortitanium, for example. In various instances, the sheet of material 130can be substantially flat and/or smooth. Moreover, in certain instances,the sheet of material 130 can be bent, folded, contoured and/or crimpedat various regions, such as a first region 134 and a second region 136,for example. The sheet of material 130 can be bent using a punch and/orstamp, for example. Flat or substantially flat portions 135 a, 135 b,and 135 c of the sheet of material 130 can be positioned intermediatethe regions 134, 136, for example. The first region 134 can beintermediate the flat portions 135 a and 135 b, for example, and thesecond region 136 can be intermediate the flat portions 135 b and 135 c,for example. In various instances, the flat portions 135 a and 135 c canbe coplanar, for example, and/or the flat portion 135 b can be paralleland/or substantially parallel to the flat portions 135 a and/or 135 c,for example. Referring primarily to FIG. 158A, multiple flat sheets 130a, 130 b, 130 c, 130 d, 130 e, 130 f can be stacked, and then bent atthe regions 134 and 136 simultaneously. In other embodiments, the sheets130 a, 130 b, 130 c, 130 d, 130 e, 130 f can be individually bent, forexample, and then stacked.

In various instances, the staples 160 can be cut, formed and/or stampedfrom the bent sheets 130. For example, referring primarily to FIG. 158B,a staple outline 132 can be traced, etched, and/or cut into the bentsheets 130. The staple outline 132 can be machined and/or laser cut intothe bent sheets 130, for example. In various instances, an electrondischarge machining (EDM) wire 138 can be used to cut the staple outline132. Furthermore, in certain instances, multiple stacked sheets 130 canbe cut simultaneously. In certain embodiments, referring primarily toFIG. 158C, the staple outline 132 can form the boundary or perimeter ofthe staple 160. For example, the staple outline 132 can form the staple160 (FIGS. 132-139 and 159-162 ), and/or can form a staple havingvarious similar features to the staple 160, for example. In variousinstances, multiple staple outlines 132 can be cut into the sheet ofmaterial 130, and multiple staples 160 can be formed from a single sheetof material 130. As illustrated in FIGS. 158B and 158C, the EDM wire 138can pass through more than one sheet of material 130 at a time to cutmore than one staple 160 at a time. While six sheets 130 are beingsimultaneously cut by the EDM wire 138, any suitable number of sheets130 can be cut at the same time. For instance, a wire 138 can cut lessthan six sheets 130 at the same time or more than six sheets 130 at thesame time.

For example, referring to FIGS. 158C and 159-162 , the staple outline132 can form the base 162 and/or the staple legs 164, 166, for example.Furthermore, the staple outline 132 can include at least oneintegrally-formed staple drive surface. For example, the staple outline132 can include the initial drive surface 180 and/or the secondary drivesurface 182. In other words, the initial drive surface 180 and/or thesecondary drive surface 182 can be machined and/or formed at the timethe staple 160 is cut from the sheet of material 130. In certaininstances, the bent or contoured regions 134, 136 of the sheet 130(FIGS. 158A and 158B) can form the contoured portions 178 of the staple160. Moreover, the lateral flat portions 135 a and 135 c of the sheet130 (FIGS. 158A and 158B) can correspond to the staple legs 164 and 166,and the intermediate flat portion 135 b of the sheet 130 (FIGS. 158A and158B) can correspond to the intermediate portion 172 of the base 162,for example.

In various instances, the depth D₁ (FIGS. 160 and 162 ) of the staple160 can determined by the depth of the sheet of material 130. Forexample, the sheet of material 130 can be selected based on the depththereof, and the staple 160 formed from that sheet of material 130 canhave the same depth as the sheet of material 130. Furthermore, theheight H₁ (FIG. 161 ), and width W₁ (FIG. 161 ) of the base 162 and thestaple legs 164, 166 can be determined by the staple outline 132. Invarious instances, the staple outline 132 can provide variations in theheight and/or width of the staple components along the length of eachcomponent. For example, the height H₁ of the base 162 and/or the widthW₁ of the staple legs 164, 166 can vary along the length thereof.Furthermore, tapers, steps, and/or other variations can be defined bythe staple outline 132, and thus, the geometry of the staple 160 can beselected and/or manipulated based on the purpose, application, and/ordesign of the staple 160 and/or the end effector 120 with which thestaple 160 may be used.

Referring primarily to FIGS. 159-162 , in various instances, the staple160 can be cut such that the height H₁ of the base 162 is independent ofand/or different than the depth D₁ of the staple legs 164, 166. Forexample, the depth D₁ of the staple legs 164, 166 can correspond to thedepth of the sheet of material 130, and the base 162 can be cut to anappropriate height H₁, which can be independent of the depth of thesheet of material 130 and/or the corresponding leg depth D₁, for exampleThe appropriate height H₁ can be based on the purpose, application,and/or design of the staples 160 and/or the end effector 120 (FIG. 129 )with which the staple 160 may be used, for example. Furthermore, theheight H₁ of the base 162 can also vary along the length thereof. Forexample, the height H₁ can vary at and/or near a drive surface of thestaple 160, and/or at a gusset between one of the staple legs 164, 166and the base 162, for example. The staple outline 132 can provide atleast one taper and/or step along the length of the base 162, forexample. The staple outline 132 can comprise a taper or ramp, forexample, which can form the secondary drive surface 182 of the base 162.The degree of incline of the secondary drive surface 182 can beselected, designed and implemented via the staple outline 132. Incertain embodiments, the height H₁ of the base 162 can be greater thanthe depth D₁ of the staple legs 164, 166. In other embodiments, theheight H₁ of the base 162 can be equal to or less than the depth D₁ ofthe staple legs 164, 166. Comparatively, the geometry of a staple thatis formed from a bent wire may be constrained and/or limited based onthe dimensions of the initial wire. For example, in a wire-formedstaple, the height of the staple base typically corresponds to the widthof the staple legs, which typically corresponds to the diameter of thewire. Though drawing and/or rolling, for example, can modify thediameter of the wire, the volume of material limits and/or restrains thepermissible modifications.

In various instances, the width W₁ of the staple legs 164, 166 can alsobe independent of the depth D₁ of the staple legs 164, 166 and theheight H₁ of the base 162, for example. The staple legs 164, 166 can becut to an appropriate width W₁ based on the application, purpose and/ordesign of the staple 160 and/or the end effector 120 (FIG. 129 ) withwhich the staple 160 may be used, for example. In certain embodiments,the staple legs 164, 166 can comprise different widths, for example,and/or the width of the staple legs 164, 166 can taper, step, orotherwise vary along the length thereof. For example, the staple legs164, 166 can taper at the tips 174 to form a piercing edge or point.

Referring now to FIGS. 163-166 , a staple outline 232 can be traced,cut, etched, and/or machined into the sheet of material 130 (FIGS. 158Aand 158B), and a staple 260, similar to the staple 160 (FIGS. 159-162 ),for example, can be formed from the sheet of material 130. For example,the staple 260 can include a base 262 and staple legs 264, 266 extendingfrom the base 262. In various embodiments, the staple 260 can includecontoured portions 278, which can correspond to the bent and/orcontoured regions 134, 136 of the sheet of material 130 (FIGS. 158A and158B) from which the staple 260 was formed. In certain embodiments, thestaple 260 can include an intermediate portion 272 between the contouredportions 278, for example. Moreover, at least one drive surface 280, 282can be formed along the perimeter of the staple 260 via the stapleoutline 232.

Similar to the staple 160, the depth D₁ of the staples legs 264, 266 cancorrespond to the depth of the sheet of material 130. Furthermore, invarious instances, the height H₂ of the staple base 262 can beindependent of the depth D₁ of the staple legs 264, 266 and/orindependent of the depth of the sheet of material 130. For example, asdepicted in FIGS. 163-166 , the height H₂ of the staple base 262 is lessthan the height H₁ of the staple base 162 (FIGS. 159-162 ), and thedepth D₂ of the staples legs 264, 266 is equal to the depth D₁ of thestaple legs 164, 166, for example. In various embodiments, the width W₂of the staple legs 264, 266 can also be independent of the depth D₂ ofthe staple legs 264, 266. The height H₁ of the staple base 262 and thewidth W₂ of the staple legs 264, 266 can be selected based on thepurpose, application, and/or design of the staple 260 and/or the endeffector 120 (FIG. 129 ), for example.

Referring now to FIGS. 167-170 , a staple outline 332 can be traced,cut, etched, and/or machined into the sheet of material 130 (FIGS. 158Aand 158B), and a staple 360, similar to the staples 160 and 260 (FIGS.159-166 ), for example, can be formed from the sheet of material 130.For example, the staple 360 can include a base 362 and staple legs 364,366 extending from the base 362. In various embodiments, the staple 360can include contoured portions 378, which can correspond to the bentand/or contoured regions 134, 136 of the sheet of material 130 (FIGS.158A and 158B) from which the staple 360 was formed. In certainembodiments, the staple 360 can include an intermediate portion 372between the contoured portions 378, for example. Moreover, at least onedrive surface 380 and 382 can be formed along the perimeter of thestaple 360 via the staple outline 332.

Similar to the staples 160 and 260, the depth D₃ of the staples legs364, 366 can correspond to the depth of the sheet of material 130.Furthermore, in various instances, the height H₃ of the staple base 362can be independent of the depth D₃ of the staple legs 364, 366 and/orindependent of the depth of the sheet of material 130. For example, asdepicted in FIGS. 167-170 , the height H₃ of the staple base 362 isgreater than the height H₁ of the staple base 162 (FIGS. 159-162 ) andgreater than the height H₂ of the staple base 262 (FIGS. 163-166 ), andthe depth D₃ of the staples legs 364, 366 is equal to the depth D₁ ofthe staple legs 164, 166 and equal to the depth D₂ of the staple legs264, 266, for example. In various embodiments, the width W₃ of thestaple legs 364, 366 can also be independent of the depth D₃ of thestaple legs 364, 366. The height H₃ of the staple base 362 and the widthW₃ of the staple legs 364, 366 can be selected based on the purpose,application, and/or design of the staple 360 and/or the end effector 120(FIG. 129 ), for example.

Referring now to FIGS. 174-177 , a staple, such as a staple 460, forexample, can be used in a staple cartridge, such as the staple cartridge140 (FIGS. 129-131 ) and/or the staple cartridge 240 (FIGS. 171-173 ),for example. The staple 460 can include a base 462 having a proximalportion 468 and a distal portion 470. An intermediate base portion 472can be positioned between the proximal portion 468 and the distalportion 470, for example. As depicted in FIGS. 174-177 , a first stapleleg 464 can extend from the proximal portion 468 of the base 462, and asecond staple leg 466 can extend from the distal portion 470 of thebase. In various instances, the staple legs 464, 466 can be cylindricalor substantially cylindrical, for example, and can include a staple tip474, which can be tapered and/or include a sharp edge or point forpiercing tissue, for example. In other embodiments, the staple legs 464,466 can include a rounded and/or polygonal perimeter, for example. Theintermediate portion 472 of the staple base 462 can include atissue-contacting surface 473, which can be flat or substantially flat,for example. In various instances, the staple 460 can be formed from awire, for example, which can be bent, twisted, and/or otherwisemanipulated to form the staple legs 464, 466 and/or the staple base 462,for example. In various embodiments, the diameter of the wire can definethe width and depth of the staple legs 464, 466, for example. In someembodiments, the wire can be drawn and/or rolled to modify thedimensions of the staple 460. In certain instances, the intermediateportion 462 of the wire base 462 can be formed and/or flattened to formthe tissue-contacting surface 473. In various instances, the base 462can be flattened between two parallel or substantially parallel plates,for example, such that the tissue-contacting surface 473 and a bottomsurface 475 of the base 462 are flat or substantially flat and/orparallel or substantially parallel. Modifications to the base 162 may belimited and/or constrained by the volume of material of the wire, forexample.

Referring still to FIGS. 174-177 , the staple 460 can include chamfersand/or gussets. For example, a chamfer 484 can extend between the firststaple leg 464 and the base 462, and/or a chamfer 484 can extend betweenthe second staple leg 466 and the base 462. In certain embodiments, thechamfers 484 can be asymmetrical relative to a longitudinal axis G (FIG.175 ) extending between the first staple leg 464 and the second stapleleg 466, and/or relative to a vertical axis H (FIG. 177 ) extendingalong the length of the staple legs 464, 466, for example. The chamfers484 can extend away from the axis G and/or the axis H, for example, andthus, in certain embodiments, the intermediate portion 472 of the base462 can be offset from the axis G and/or the axis H. For example, thecenter of mass of the base 462 can be offset from the plane defined bythe axis G and the axis H. In various instances, the offset intermediateportion 472 of the base 462 can form a wide and/or flat surface forcontacting captured tissue, which can provide a broad and/or smoothsurface for applying and/or distributing pressure on the capturedtissue. In such embodiments, tissue tearing and/or trauma within thestaple 460 may be reduced and/or minimized. Moreover, similar to thestaples 160, 260, and/or 360 described herein, the staple 460 caninclude a leg formation plane, e.g., the plane defined by the axis G andthe axis H, which can be offset from the center of mass of the base 462of the staple 460, for example.

Referring now to FIGS. 178-181 , a staple, such as a staple 560, forexample, can be used in a staple cartridge, such as the staple cartridge140 (FIGS. 129-131 ) and/or the staple cartridge 240 (FIGS. 171-173 ),for example. The staple 560 can include a base 562 having a proximalportion 568 and a distal portion 570. An intermediate base portion 572can be positioned between the proximal portion 568 and the distalportion 570, for example. As depicted in FIGS. 178-181 , a first stapleleg 564 can extend from the proximal portion 568 of the base 562, and asecond staple leg 566 can extend from the distal portion 570 of the base562. In certain embodiments, the intermediate portion 572 of the base560 can extend along an axis D (FIG. 179 ), which can be parallel and/orsubstantially parallel to an axis C (FIG. 179 ) defined between thefirst staple leg 564 and the second staple leg 566, for example.

In various instances, the staple legs 564, 566 can be cylindrical orsubstantially cylindrical, for example, and can include a staple tip574, which can be tapered and/or include a sharp edge or point forpiercing tissue, for example. In various instances, the staple 560 canbe formed from a wire. For example, a wire can be bent, twisted and/orotherwise manipulated to form the staple 560. Referring still to FIGS.178-181 , the wire can be manipulated at curves 579 a, 579 b, 579 c,and/or 579 d. For example, the staple base 562 can include angledportions 578, which can be angularly oriented relative to theintermediate portion 572 of the staple base 562 and/or relative to theaxis C defined between the first and second staple legs 564, 566, forexample. In various embodiments, the wire forming the staple 560 cancurve at 579 a between the first staple leg 564 and the angled portion578 a, curve at 579 b between the angled portion 578 a and theintermediate portion 572, curve at 579 c between the intermediateportion 572 and the angled portion 578 b, and/or curve at 579 d betweenthe angled portion 578 b and second staple leg 566, for example. Forexample, the intermediate portion 572 of the base 562 can be laterallyoffset from the axis C (FIG. 179 ) extending between the first stapleleg 564 and the second staple leg 566.

In various embodiments, the diameter of the wire can define the widthand depth of the staple legs 564, 566 and/or the staple base 562, forexample. In some embodiments, the wire and/or portions thereof can bedrawn and/or rolled to modify the dimensions of the staple 560 and/orelements of the staple 560. Furthermore, the wire can have a roundedand/or polygonal perimeter. In certain embodiments, the wire can be cutat an angle to form the staple tips 574, for example. Similar to thestaples 160, 260, 360 and/or 460 described herein, the staple 560 caninclude a leg formation plane, e.g., the plane defined by the axis C,which can be offset from the center of mass of the base 562 of thestaple 560, for example.

Further to the above, turning now to FIG. 191 , an end effector, such asend effector 120, for example, can include a staple cartridge 240positioned within an elongate channel 122 and, in addition, an anvil 124positionable opposite the staple cartridge 240. In various instances,the cartridge 240 can include a plurality of staple cavities 244, afastener, such as staple 460, for example, positioned in each of thestaple cavities 244, and a longitudinal slot 243 configured to slidablyreceive a knife 158 therein. While staples 460 are depicted inconnection with the embodiment depicted in FIG. 191 , any suitablestaple or fastener could be used with this embodiment, such as staples160, for example. Referring generally to FIGS. 199 and 200 , the endeffector 120 can extend from a shaft 114 which can include a closuretube 115. When the closure tube 115 is advanced distally, the closuretube 115 can contact the anvil 124 and rotate the anvil 124 between anopen position (FIG. 199 ) and a closed position (FIG. 200 ). Once theanvil 124 has been closed, the knife 158 can be advanced distally totransect tissue captured between the anvil 124 and the cartridge 240. Incertain end effectors disclosed herein, the cartridge positioned withinthe end effector 120 can further include a fastener firing actuator,such as sled 190, for example, which is pushed distally by the knife 158to deploy staples from the cartridge at the same time that the knife 158transects the tissue. With regard to the embodiment depicted in FIG. 191, a staple cartridge can include a fastener firing actuator, such assled assembly 790, for example, which can be advanced distally with, oralongside, the knife 158 to eject the staples 460 from the cartridge240. For instance, the shaft 114 of the stapler can include a firing bar157 configured to advance the knife 158 and, in addition, pusher bars159 configured to advance the sled assembly 790. While the firing bar157 and the pusher bars 159 may be advanced concurrently, in variouscircumstances, their operation can be timed in such a way that theirinitial distal movement can be staggered relative to one another, asdescribed in greater detail further below. In addition to the initialrelative movement between the firing bar 157 and the pusher bars 159,the sled assembly 790 can include two or more portions which can moverelative to one another, as will also be described in greater detailfurther below.

Referring primarily to FIGS. 192-195 , the sled assembly 790 can includea first sled portion 792 and a second sled portion 793. The first sledportion 792 can include an inner ramp portion 791 a and an outer rampportion 791 b. As illustrated in FIGS. 192 and 193 , the outer rampportion 791 b is positioned laterally with respect to the inner rampportion 791 a. The outer ramp portion 791 b also extends distally withrespect to the inner ramp portion 791 a. Similarly, the second sledportion 793 can include an inner ramp portion 794 a and an outer rampportion 794 b. As illustrated in FIGS. 194 and 195 , the outer rampportion 794 b is positioned laterally with respect to the inner rampportion 794 a. The outer ramp portion 794 b also extends distally withrespect to the inner ramp portion 794 a. In various instances, the innerramp portion 791 a can be configured to lift, or at least partiallylift, an inner row of staples while the outer ramp portion 791 b can beconfigured to lift, or at least partially lift, an outer row of staples.As primarily depicted in FIG. 193 , the inner ramp portion 791 a and theouter ramp portion 791 b can each include a ramp surface, such as rampsurfaces 795 a and 795 b, respectively, which can slide underneath thestaples in the inner row of staples and the outer row of staples,respectively. The ramp surfaces 795 a and 795 b of the inner rampportion 791 a and the outer ramp portion 791 b can be configured to liftstaples from an unfired position to an at least partially-firedposition. In various instances, the ramp surfaces 795 a and 795 b of theinner ramp portion 791 a and the outer ramp portion 791 b can eachcomprise at least one inclined surface, curved surface, actuate surface,and/or convex surface, for example.

Further to the above, the inner ramp portion 794 a of the second sledportion 793 can include an inner ramp surface 796 a and, similarly, theouter ramp portion 794 b of the second sled portion 793 can include anouter ramp surface 796 b. In various instances, the inner ramp surface795 a of the first sled portion 792 can be configured to co-operate withthe inner ramp surface 796 a of the second sled portion 793 to lift thestaples in the inner row of staples from their unfired positions andtheir fully-fired positions. More particularly, the inner ramp portion791 a can lift the staples in the inner row of staples from an unfiredposition to a partially-fired position wherein the inner ramp portion794 a can then lift the staples from their partially-fired positions toa fully-fired position, for instance. In such circumstances, the liftingmotion of the staples in the inner row of staples can be initiated bythe inner ramp portion 791 a of the first sled portion 792, transferredto the inner ramp surface 796 a of the second ramp portion 793, and thencompleted by the second ramp portion 793. Similarly, the outer rampsurface 795 b of the first sled portion 792 can be configured toco-operate with the outer ramp surface 796 b of the second sled portion793 to lift the staples in the outer row of staples from their unfiredpositions and their fully-fired positions. More particularly, the outerramp portion 791 b can lift the staples in the outer row of staples froman unfired position to a partially-fired position wherein the outer rampportion 794 b can then lift the staples from their partially-firedpositions to a fully-fired position, for instance. In suchcircumstances, the lifting motion of the staples in the outer row ofstaples can be initiated by the outer ramp portion 791 b of the firstsled portion 792, transferred to the outer ramp surface 796 b of thesecond ramp portion 793, and then completed by the second ramp portion793. The firing, or lifting, motion of the staples in the inner row ofstaples can be completed once the apex 798 of the inner ramp portion 794a has passed underneath the staples. Similarly, the firing, or lifting,motion of the staples in the outer row of staples can be completed oncethe apex 798 of the outer ramp portion 794 b has passed underneath thestaples.

Referring again to FIG. 191 , the sled assembly 790 can include morethan one first sled portion 792 and/or more than one second sled portion793. In various instances, the sled assembly 790 can comprise a firstset of sled portions comprising a first sled portion 792 and a secondsled portion 793 and a second set of sled portions comprising a firstsled portion 792 and a second sled portion 793. In certain instances,the second set of sled portions can constitute a mirror image of thefirst set. For the purposes of simplifying the description of the sledassembly 790 herein, reference may be made to only one set of sledportions; however, the reader should appreciate that the descriptionregarding the operation of one set of sled portions could also apply tothe concurrent operation of any suitable number sets of sled portions.

Further to the above, the outer staple rows of the cartridge 240, i.e.,the rows furthest away from the channel 243, can lead the inner staplerows, i.e., the rows closest to the channel 243. Stated another way, thedeformation of the staples in the outer row can begin before, or atleast slightly before, the deformation of the laterally adjacent staplesin the inner row. In other instances, the outer staple rows of thecartridge 240, i.e., the rows furthest away from the channel 243, canlag the inner staple rows, i.e., the rows closest to the channel 243.Stated another way, the deformation of the staples in the inner row canbegin before, or at least slightly before, the deformation of thelaterally adjacent staples in the outer row. Moreover, while two staplesrows are disclosed on each side of the channel 243 defined in thecartridge 240, other embodiments are envisioned in which more than twostaple rows, such as three staple rows, for example, are present on eachside of the channel 243. In such embodiments, the sled assemblies can beconfigured to deploy an additional row of staples at the same time asthe inner row of staples, at the same time as the outer row of staples,and/or at a time which is staged sequentially with respect to the innerrow of staples and the outer row of staples.

As mentioned above, the first sled portion 792 is movable relative tothe second sled portion 793 of the sled assembly 790. Turning now toFIGS. 196-198 , the sled assembly 790 is movable between an initial,unfired configuration (FIG. 196 ) and a second, extended configuration(FIGS. 197 and 198 ). In the initial, unfired configuration of sledassembly 790, referring primarily to FIG. 196 , the first sled portion792 is collapsed within, or retracted relative to, the second portion793. In at least one such instance, the distal end of the first sledportion 792 may not extend beyond the distal end of the second sledportion 793. In other instances, although not illustrated, the distalend of the first sled portion 792 may extend beyond the distal end ofthe second sled portion 793 when the first sled portion 792 is collapsedwithin the second portion 793. With further reference to FIG. 196 , thereader will further appreciate that the staples 460 are in an unfiredposition as they have not yet been lifted toward the anvil 124. Uponcomparing FIGS. 196 and 197 , the reader will notice that the first sledportion 792 has been extended relative to the second sled portion 793.In such circumstances, the distal end of the first sled portion 792 ispositioned distally with respect to the distal end of the second sledportion 793. The movement of the first sled portion 792 from itsinitial, unfired position to its extended position can position theinner ramp portion 791 a and/or the outer ramp portion 791 b of thefirst sled portion 792 underneath one or more staples 460. In otherconfigurations, the movement of the first sled portion 792 from itsinitial, unfired position to its extended position may not position theinner ramp portion 791 a and/or the outer ramp portion 791 b underneathone or more staples 460. In any event, as illustrated in FIG. 197 , theextension of the first sled portion 792 can at least partially lift atleast one staple 460 toward the anvil 124 and/or at least partiallydeform at least one staple 460 against the anvil 124. In certaininstances, the extension of the first sled portion 792 can completelylift, or completely deform, at least one staple 460 against the anvil124. In various circumstances, the second sled portion 793 may not beadvanced distally when the first sled portion 792 is moved into itsextended position; however, in certain circumstances, at least somedistal movement of the second sled portion 793 may occur when the firstsled portion 792 is moved into its extended position.

Upon comparing FIGS. 197 and 198 , it can be noted that the first sledportion 792 and the second sled portion 793 have been advanced distallyto lift staples 460 toward the anvil 124. The first sled portion 792 andthe second sled portion 793 can then be advanced to the distal end ofthe end effector 120 to complete the firing stroke of the end effector120, which will be discussed in greater detail further below. In anyevent, the initial progression of the sled assembly 790 during thefiring stroke of the end effector 120 is depicted in FIGS. 196-198 .FIG. 196 depicts the sled assembly 790 in a retracted, unfired position;FIG. 197 depicts the sled assembly 790 in an extended, partially-firedposition; and FIG. 198 depicts the sled assembly 790 in an extended,fired position. As outlined above, the pusher bar, or bars, 159 can bemoved distally in order to advance the sled assembly 790 through theprogression depicted in FIGS. 196-198. With reference to FIG. 196 , apusher bar 159 is illustrated in an initial, unfired position in whichit is in contact with the proximal end of the first sled portion 792. Invarious embodiments, the pusher bar 159 can include a contact flange 155extending from the distal end thereof which can engage the first sledportion 792. With further reference to FIG. 196 , the pusher bar 159 maynot be in contact with the second sled portion 793 when the pusher bar159 is in its initial, unfired position. As the pusher bar 159 isadvanced distally, the pusher bar 159 can move the first sled portion792 distally until the contact flange 155 comes into contact with theproximal end of the second sled portion 793, as illustrated in FIG. 197. It is this relative motion between the first sled portion 792 and thesecond sled portion 793 which extends the sled assembly 790 as discussedabove. Thereafter, the pusher bar 159 can be advanced distally in orderto advance the first sled portion 792 and the second sled portion 793distally at the same time, as illustrated in FIG. 198 .

As discussed above, the end effector 120 can be configured to staple andtransect tissue at the same time. Referring again to FIG. 191 , the endeffector 120 can include a firing member, or knife bar, 156 comprising aknife edge 158 configured to transect the tissue as the knife bar 156 isadvanced distally. Referring again to FIGS. 196 and 197 , the initialdistal movement of the pusher bar, or bars, 159 may not be transferredto the knife bar 156. Stated another way, the knife bar 156 may remainstationary, or at least substantially stationary, while the sledassembly 790 is moved between its retracted position (FIG. 196 ) and itsextended position (FIG. 197 ). In such circumstances, relative movementbetween the pusher bars 159 and the knife bar 156 can occur, at leastduring the initial portion of the end effector firing stroke. Uponcomparing FIGS. 200 and 203 , it can be seen that, one, the pusher bars159 have been advanced distally to extend the sled assembly 790 and,two, the knife bar 156 has not been advanced distally. Particularattention can be paid to the proximal ends of the knife bar 156 and thepusher bars 159. More particularly, the pusher bars 159 can include adrive pin 759 extending therebetween which extends through a drive slot757 defined in the drive bar 157 extending proximally from the knife bar156. When the pusher bars 159 are in their proximal unfired position, asillustrated in FIG. 200 , the drive pin 759 is positioned in theproximal end of the drive slot 757. When the pusher bars 159 areadvanced distally, as illustrated in FIG. 203 , the drive pin 759 canslide distally within the drive slot 757 until the drive pin 759 reachesthe distal end of the drive slot 757. In such a position, the sled 790has been fully extended and the knife bar 156 has not yet been advanceddistally with the pusher bars 159. Once the drive pin 759 is in contactwith the distal end of the drive slot 757, as illustrated in FIGS. 204and 205 , the pusher bars 156 and the knife bar 159 can be advanceddistally together.

Further to the above, the knife bar 156 can include flanges 153 and 155which can be configured to engage the anvil 124 and the staple cartridgechannel 123, respectively. When the knife bar 156 is in its proximal,unadvanced position, as illustrated in FIG. 203 , the flange 153 can bepositioned proximally with respect to a slot 121 defined in the anvil124. In such a position of the knife bar 156, the flange 155 may or maynot be positioned within a slot defined within and/or in the exterior ofthe cartridge channel 123. As the knife bar 156 is advanced distally,the flange 153 can enter into the anvil slot 121 and the flange 155 canbe positioned within the cartridge channel slot. In such circumstances,the knife bar 156 can set the gap, or tissue gap distance, between theanvil 124 and the staple cartridge positioned within the cartridgechannel 123. In various circumstances, the knife bar 156 can control theforming height and/or the compression of the tissue within the endeffector 120 as the knife bar 156 is advanced distally.

The arrangement described above in which the pusher bars 159 move thesled assembly 790 before the pusher bars 159 advance the knife 158 canbe advantageous in many circumstances. For instance, it is oftendesirable to staple tissue before it is incised and, thus, the formationof the staples leads, or at least sufficiently leads, the transection ofthe tissue by the knife bar 156. The staggered deployment of the sled790 and the knife bar 156 can facilitate such a relative progressionbetween the staple formation and the tissue incision. Moreover, the sled790 can be compactly stored in the end effector 120 in its retracted,unfired configuration in order to permit a shorter proximal-to-distal,or longitudinal, length of the end effector 120. Stated another way,less longitudinal room may be required for a sled assembly that canbegin its firing stroke in at least partially collapsed state.Furthermore, owing to the longitudinal extendibility of the sledassembly 790, the staple lifting surfaces of the sled assembly 790 canbe longer and can include a shallower, or less aggressive, ramp anglethan a unitary sled, for instance. Stated another way, the mechanicaladvantage of the sled assembly 790 can be improved owing to longerlongitudinal lengths available for the ramps of the sled assembly 790.

Turning now to FIGS. 206-208 , the sled assembly 790 and the knife bar156 can be advanced distally toward the distal end of the end effector120 to complete the firing stroke of the end effector 120. As the sled790 approaches the distal end of the end effector 120, in variousinstances, the first sled portion 792 can contact a distal end 245 ofthe staple cartridge and retract relative to and/or within the secondsled portion 793. More particularly, the distal end 245 can block thedistal movement of the first sled portion 792 while the second sledportion 793 is advanced distally relative to the first sled portion 792in order to complete the firing stroke. In various instances, the secondsled portion 793 can be advanced distally until it also contacts thedistal end 245 of the staple cartridge while, in other instances, thefiring stroke can be completed before the second sled portion 793contacts the distal end 245. In either event, in embodiments where thedistal flanges 155 of the pusher bars 159 push the first sled portion792 and the second sled portion 793 toward the distal end of the endeffector 120, the first sled portion 792 may become disengaged from thepusher bars 159 when the first sled portion 792 reaches the distal endso that that the pusher bars 159 can push the second sled portion 793relative to the first sled portion 792. In at least one such instance,referring primarily to FIG. 203 , the distal end of the staple cartridgecan include a boss 241 which can be configured to lift the first sledportion 792 upwardly toward the anvil 124 so that the pusher bars 159can slide underneath the first sled portion 792. In such circumstances,the first sled portion 792 can be operatively disengaged from the secondsled portion 793 and the pusher bars 159. In various instances, the boss241 can be positioned and arranged such that the first sled portion 792is lifted upwardly after all of the staples of the staple cartridge havebeen deployed and/or transferred to the second sled portion 793, asdiscussed above. Moreover, further to the above, the distal end of thestaple cartridge can include a first boss 241 configured to lift a firstsled portion 792 and a second boss 241 configured to lift an additionalfirst sled portion 792. In various instances, the bosses 241 can beconfigured to synchronously lift the first sled portions 792 at the sametime. In some instances, the bosses 241 can be configured to lift thefirst sled portions 792 sequentially.

Referring now to FIGS. 211-214 , FIG. 211 depicts the sled assembly 790in its initial, unfired configuration. Further to the above, a pusherbar 159 can contact a proximal end 789 of the first sled portion 792 andpush the first sled portion 792 distally until the proximal end 789 ofthe first sled portion 792 is flush with a proximal end 787 of thesecond sled portion 793, as illustrated in FIG. 212 . At such point, thefirst sled portion 792 can be fully extended relative to the second sledportion 793. Thereafter, the pusher bar 156 can push on the proximal end787 and the proximal end 789 simultaneously to advance the sled assembly790 distally. As also discussed above, referring now to FIG. 213 , thefirst sled portion 792 can be stopped by the distal end 245 of thestaple cartridge and lifted upwardly by the boss 241 of the staplecartridge, for instance. At such point, the first sled portion 792 canbe elevated relative to the second sled portion 793, and the distalflange 155, such that the second sled portion 793 can be slid relativeto, and at least partially underneath, the first sled portion 792, inorder to collapse the sled assembly 790, as illustrated in FIG. 214 .Upon comparing FIGS. 213 and 214 , it can be seen that the second sledportion 793 is moved closer toward ledge 788 defined in the bottomsurface of the first sled portion 792 and that the distal end 789 of thefirst sled portion 792 is no longer aligned with the distal end 787 ofthe second sled portion 793.

After the firing stroke has been completed, referring now to FIGS. 209and 210 , the knife bar 156 and the pusher bars 159 can be retractedproximally. In various circumstances, the knife bar 156 can be pulledproximally by the pusher bars 159. More particularly, the pusher bars159 can be retracted proximally relative to the knife bar 159 until thedrive pin 759 contacts the proximal end of the drive slot 759. At suchpoint, the pusher bars 159 can pull the knife bar 156 proximally untilthe flange 153 of the knife bar 156 is no longer positioned within theslot 121 of the anvil 124. Thereafter, the anvil 124 can be moved intoits open position when the closure tube 115 is pulled proximally. Incertain instances, the staple cartridge can comprise a replaceablestaple cartridge. In such instances, the spent staple cartridge can beremoved from the cartridge channel 122 and, if desired, an unspentstaple cartridge can be positioned within the cartridge channel 122 sothat the surgical instrument can be used once again.

As illustrated in FIGS. 209 and 210 , the collapsed sled assembly 790can be left behind in the distal end of the end effector 120 when theknife bar 156 and the pusher bars 159 are retracted. In the event thatthe spent staple cartridge is removed from the cartridge channel 122,the collapsed sled assembly 790 can be removed from the end effector 120with the cartridge. In certain instances, a staple cartridge may not becompletely spent before the pusher bars 159 and the knife bar 156 areretracted. In such instances, the sled assembly 790 may only bepartially advanced within the staple cartridge and may not be collapsedback into its unextended configuration. When the staple cartridge isthen removed from the cartridge channel 123, some of the staples maystill be positioned within their staple cavities.

As discussed herein, a firing actuator, or sled, of a staple cartridgeand/or stapling instrument can include one or more inclined rampsurfaces configured to lift, or deploy, staples between an unfiredposition and a fired position. For instance, a sled can include a firstinclined ramp surface configured to deploy a first row of staples, asecond inclined ramp surface configured to deploy a second row ofstaples, and so forth. Each inclined ramp surface can comprise acontiguous surface which is configured to engage each staple in thecorresponding row of staples and lift the staples until they have beenfully deformed against an anvil positioned opposite the staplecartridge. The contiguous surface which defines each inclined rampsurface can include any suitable number of contours such as, forinstance, one or more linear surfaces and/or one or more curvedsurfaces. In various instances, the contiguous surface can directlyengage each staple in the corresponding row of staples and can remaincontinuously engaged with a staple in that row as it moved from itsunfired position to its fully-fired position. After a staple has reachedits fully-fired position, the inclined ramp surface may becomedisengaged from that staple. This arrangement can be possible for sledswith relatively movable components, such as sled assembly 790, forinstance, and/or sleds that are not comprised of relatively movablecomponents, such as sleds comprised of a unitary piece of material, forexample.

In various circumstances, a firing actuator, or sled, can comprise oneor more inclined ramp surfaces, wherein each inclined ramped surface iscomprised of two or more co-operating drive surfaces. For instance,turning now to FIG. 218 , a sled 890 can include a first inclined rampsurface 891 a which is comprised of an initial, or first, drive surface895 a and a second, or final, drive surface 896 a. The initial drivesurface 895 a and the final drive surface 896 a of the first inclinedramp surface 891 a can be configured to co-operatively lift the staplesin a first staple row between an unfired position and a fired position.As the sled 890 is moved distally through a staple cartridge, referringto FIGS. 215-218 , the initial drive surface 895 a can contact a staple160, for instance, and lift the staple 160 from its unfired position(FIG. 215 ) to a partially-fired position (FIG. 216 ). Thereafter, thesled 890 can be advanced distally such that the final drive surface 896a can lift the staple 160 between its partially-fired position and itsfully-fired position. In various instances, the initial drive surface895 a can contact the initial drive surfaces 180 of the staples 160 tolift the staples 160 into their partially-fired positions and the finaldrive surface 896 a can contact the second drive surfaces 182 of thestaples 160 to lift the staples 160 into their finally-fired positions.In such instances, the staples 160 can be transferred from the initialdrive surface 895 a to the final drive surface 896 a to complete thedeployment, or firing, thereof. Referring to FIG. 218 , the deployment,or firing, of a staple 160 can be complete once the apex 898 of thefirst inclined ramp surface 891 a has passed under the second drivesurface 182 of the staple 160.

Further to the above, referring again to FIG. 218 , the initial drivesurface 895 a and the final drive surface 896 a of the first inclinedramp surface 891 a can be configured to co-operatively deploy stapleswithin a first row of staples. The sled 890 can include additionalinclined ramp surfaces to deploy additional rows of staples. Forinstance, the sled 890 can include a second inclined ramp surface 891 bcomprising an initial drive surface 895 b and a final drive surface 896b which can be configured to co-operatively deploy staples within asecond row of staples. In various instances, the sled 890 can furtherinclude any suitable number of inclined ramp surfaces, such as a thirdinclined ramp surface, similar to first inclined ramp surface 891 a,configured to deploy staples within a third row of staples and a fourthinclined ramp surface, similar to second inclined ramp surface 891 b,configured to deploy staples within a fourth row of staples, forexample. In any event, the drive surfaces of an inclined drive surface,such as drive surfaces 895 a, 895 b, 896 a, and 896 b, for example, caninclude any suitable configuration such as a linear profile and/or acurved profile, for example. With further reference to FIG. 218 , thefirst inclined ramp surface 891 a can include a transition drive surface897 a intermediate the initial drive surface 895 a and the final drivesurface 896 a. Similarly, the second inclined ramp surface 891 b caninclude a transition drive surface 897 b intermediate the initial drivesurface 895 b and the final drive surface 896 b. In various instances, atransition drive surface can comprise a transition between one drivesurface and another drive surface. In some instances, a transition drivesurface can comprise a surface which simultaneously drives the initialdrive surface 180 and the second drive surface 182 of a staple 160, forexample. In various instances, an inclined ramp surface can include anysuitable number of drive surfaces.

In various instances, further to the above, the initial drive surface895 a can be positioned laterally with respect to the final drivesurface 896 a. In certain instances, the initial drive surface 895 a andthe final drive surface 896 a can be connected to one another. In otherinstances, the initial drive surface 895 a and the final drive surface896 a may not be connected to one another. In various circumstances, theinitial drive surface 895 a can be defined by a first height and thefinal drive surface 896 a can be defined by a second height which istaller than the first height. In certain circumstances, the initialdrive surface 895 a can be defined along a first longitudinal axis andthe final drive surface 896 a can be defined along a second longitudinalaxis. In certain instances, the first longitudinal axis and the secondlongitudinal axis can be parallel. In some instances, the initial drivesurface 895 a can be defined by a first plane and the final drivesurface 896 a can be defined by a second plane which is parallel to thefirst plane. In other instances, the first longitudinal axis and thesecond longitudinal axis can be non-parallel. In some instances, thefirst longitudinal axis and the second longitudinal axis can extend indirections which converge. In other instances, the first longitudinalaxis and the second longitudinal axis can extend in directions which donot converge. In various instances, further to the above, the transitiondrive surface 897 a of the first inclined surface 891 a can be definedalong an axis which is parallel to the first longitudinal axis and/orthe second longitudinal axis. In certain instances, the transition drivesurface 897 a can be defined along an axis which is not parallel to thefirst longitudinal axis and/or the second longitudinal axis. In variousinstances, further to the above, the transition drive surface 897 a ofthe first inclined surface 891 a can be defined within a plane which isparallel to the first plane and/or the second plane. In some instances,the transition drive surface 897 a can be co-planar with the initialdrive surface 895 a and/or the final drive surface 896 a. In certaininstances, the transition drive surface 897 a can be defined within aplane which is different than the first plane and/or the second plane.In various instances, further to the above, the transition drive surface897 a can connect the initial drive surface 895 a to the final drivesurface 896 a.

The discussion provided above in connection with inclined ramp surface891 a, initial drive surface 895 a, final drive surface 896 a, andtransition drive surface 897 a can be equally applicable to inclinedramp surface 891 b, initial drive surface 895 b, final drive surface 896b, and transition drive surface 897 b, for example.

In various circumstances, further to the above, the first inclined rampsurface 891 a can be parallel to the second inclined ramp surface 891 b.In other instances, the first inclined ramp surface 891 a may not beparallel to the second inclined ramp surface 891 b. In variousinstances, the first inclined ramp surface 891 a can be defined by afirst height and the second inclined ramp surface 891 b can be definedby a second height. In some instances, the first height can be the sameas the second height. In such instances, a first row of staples formedby the first inclined ramp surface 891 a and a second row of staplesformed by the second inclined ramp surface 891 b can be formed to thesame height. In other instances, the first height can be different thatthe second height. In such instances, a first row of staples formed bythe first inclined ramp surface 891 a and a second row of staples formedby the second inclined ramp surface 891 b can be formed to differentheights. The disclosure of U.S. Pat. No. 8,317,070, entitled SURGICALSTAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS,which issued on Nov. 27, 2012, is incorporated by reference in itsentirety.

As discussed above, a sled can directly drive and deploy a staple and/orany other suitable fastener stored within a cartridge. Stated anotherway, the sled can directly contact the staples wherein a driver is notpresent intermediate the sled and the staples. Such an arrangement isdifferent than arrangements which include a plurality of drivers whichsupport the staples. In such arrangements, the sled engages the driversto lift the staples. In these arrangements, the drivers are oftenconfigured to completely eject the staples from the staple cavities inwhich they are stored. More particularly, the drivers are configured tolift the staples such that the staples are completely positioned abovethe top surface, or deck, of the staple cartridge when the staples arein their fully-fired position. In order to completely lift the staplesabove the deck of the staple cartridge, the drivers may also be at leastpartially lifted above the deck. Such an arrangement can becharacterized as overdriving the staples. Many of the teachingsdiscussed herein can be applied to embodiments including one or moresleds which directly drive staples and, in addition, embodimentsincluding a plurality of drivers which are driven by one or more sledsin order to drive the staples. For instance, sled 890 is discussed inconnection with embodiments in which it directly drives staples 160;however, sled 890 could also be used in embodiments which includedrivers configured to deploy staples from the staple cavities. In suchembodiments, each driver could include a first drive surface similar tofirst drive surface 180 configured to be engaged by the initial drivesurface 895 a, for instance, and a second drive surface similar tosecond drive surface 182 configured to be engaged by the final drivesurface 896 a, for instance.

In the embodiments disclosed herein in which the staples are drivendirectly by the sled, i.e., without the use of drivers, further to theabove, the staples can be completely lifted above the deck, oroverdriven, by the sled itself. Turning now to FIGS. 217-220 , the sled890 is configured to partially extend above the deck surface 141 of thecartridge 142. More particularly, the apex 898 of the first inclinedramp surface 891 a and the apex 898 of the second inclined ramp surface891 b can extend above the deck surface 141 as the inclined rampsurfaces 891 a and 891 b pass through and/or between the cavities 144 toeject the staples 160, for example, from the staple cavities 144. Insuch circumstances, the sled 890 is configured to partially extend abovethe staple cavity openings defined in the deck surface 141. In variousinstances, the cartridge 142 can further comprise a plurality ofcoverings 145 positioned within and/or aligned with the rows of staplecavities 144. For instance, a covering 145 can be positionedintermediate adjacent staple cavities 144 within a staple cavity row. Incertain instances, a covering 145 can be positioned proximally and/ordistally with respect to a staple cavity 144. In various instances,referring primarily to FIG. 220 , the apexes 898 of the inclined rampsurfaces 891 can pass underneath the coverings 145. In such instances,each covering 145 can include a bottom surface, such as an arched bottomsurface 147, for example, configured to permit the inclined rampsurfaces 891 to pass thereunder. With further reference to FIG. 220 ,the cartridge 142 can include a first longitudinal slot 149 configuredto slidably receive the first inclined ramp surface 891 a therein and asecond longitudinal slot 149 configured to receive the second inclinedramp surface 891 b, for example. In various instances, the cartridge 142can include a plurality of longitudinal slots 149 configured to receivethe inclined ramp surfaces of the sled 890. In certain instances, thelongitudinal slots 149 can be defined by the coverings 145 and thestaple cavities 144. In some circumstances, each longitudinal slot 149can correspond to a longitudinal row of staple cavities 144 wherein alongitudinal slot 149 can place the staple cavities 144 within a staplecavity row in communication with each other such that an inclined rampsurface passing through the longitudinal slot 149 can pass through thestaple cavities 144 as outlined above.

In various instances, the deck of a cartridge can be configured todirectly contact the tissue being fastened and/or support the tissuebeing fastened. In certain circumstances, a cartridge assembly caninclude a layer positioned on the deck, such as a tissue thicknesscompensator, for example, which is disclosed in U.S. patent applicationSer. No. 12/894,369, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISINGA SUPPORT RETAINER, now U.S. Patent Application Publication No.2012/0080344, which was filed on Sep. 30, 2010, U.S. patent applicationSer. No. 13/097,856, entitled STAPLE CARTRIDGE COMPRISING STAPLESPOSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF, now U.S. PatentApplication Publication No. 2012/0080336, which was filed on Apr. 29,2011, and U.S. patent application Ser. No. 13/242,066, entitled CURVEDEND EFFECTOR FOR A STAPLING INSTRUMENT, now U.S. Patent ApplicationPublication No. 2012/0080498, which was filed on Sep. 23, 2011. Theentire disclosures of U.S. patent application Ser. No. 12/894,369,entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER,now U.S. Patent Application Publication No. 2012/0080344, which wasfiled on Sep. 30, 2010, U.S. patent application Ser. No. 13/097,856,entitled STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN ACOMPRESSIBLE PORTION THEREOF, now U.S. Patent Application PublicationNo. 2012/0080336, which was filed on Apr. 29, 2011, and U.S. patentapplication Ser. No. 13/242,066, entitled CURVED END EFFECTOR FOR ASTAPLING INSTRUMENT, now U.S. Patent Application Publication No.2012/0080498, which was filed on Sep. 23, 2011, are incorporated hereinby reference. In various instances, referring again to FIG. 219 , thedeck 141 and the coverings 145 can be configured to directly contacttissue. In such instances, coverings 145 can extend above the deck 141and, as a result, the deck 141 and the coverings 145 can comprise anuneven support surface. The coverings 145, in various instances, canapply an additional compressive pressure to the tissue positioneddirectly above and/or adjacent to each longitudinal row of staples. Thisadditional compressive pressure can push fluids present within thetissue away from the staple lines prior to, during, and/or after thestaple forming process which, as a result, can promote better stapleformation and/or staple retention within the tissue. The coverings 145can also be configured to grip the tissue positioned between a staplecartridge and an anvil, especially along the staple lines where thestaple formation occurs. The coverings can also be configured to supportthe staples as the staples are being ejected from the staple pockets toprovide a localized control over the staple forming process. The entiredisclosures of U.S. patent application Ser. No. 12/893,461, entitledSTAPLE CARTRIDGE, now U.S. Pat. No. 8,733,613, which was filed on Sep.29, 2010, and U.S. patent application Ser. No. 13/851,676, entitledTISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH, which wasfiled on Mar. 27, 2013, now U.S. Patent Application Publication No.2014/0291379, are incorporated by reference herein.

As discussed above, referring primarily to FIGS. 184, 187, and 190 , astaple cavity, such as staple cavity 144, for example, can include afirst sidewall 150 a and a second sidewall 150 b which can be configuredto guide a staple, such as a staple 160, for example, as it is liftedbetween an unfired position and a fired position. In various instances,the sidewalls 150 a, 150 b can be configured and arranged such that theentirety of the staple 160 is positioned intermediate the sidewalls 150a, 150 b when the staple 160 is in its unfired position. In othercircumstances, referring primarily to FIGS. 148-157 , the sidewalls 150of the staple cavity 144 may be configured such that less than theentirety of the staple 160 is positioned intermediate the sidewalls 150when the staple 160 is in its unfired position. For instance, the base162 of the staples 160 in the outermost rows of staple cavities 144defined in the cartridge body 142 may be unsupported by at least one ofthe sidewalls 150 when the staples 160 are in their unfired positions.As the staples 160 are lifted upwardly, however, the bases 162 of thestaples 160 may then be supported by both of the sidewalls 150. Turningnow to FIGS. 219 and 220 , some of the staple cavities 144 of thecartridge 142, such as cavities 144 a, for example, may only supportboth sides of the bases 162 at the end of their lifting motion. In anyevent, even though the sidewalls of the staple cavities 144 defined inthe cartridge body 142 may not entirely support the staples 160 in theirunfired positions, the cartridge channel 123 of jaw 122, referring againto FIGS. 129 and 191 , may at least partially support the staples 160.Stated another way, the cartridge body 142 and the cartridge channel 123may co-operate to define the staple cavities 144 in order to supportand/or surround the staples 160 throughout the lifting motion of thestaples 160. For instance, the cartridge body 142 and the cartridgechannel 123 can co-operate to support and/or surround a staple 160 whenthe staple 160 is in its unlifted position. At some point during thelifting motion of the staple 160, in some circumstances, the cartridgechannel 123 may no longer support and/or the staple 160 and, in suchcircumstances, the cartridge body 142 may entirely support the staple160 for the remainder of the lifting motion. In at least one embodiment,the cartridge channel 123 and the cartridge body 142 may co-operate tosupport the staple 160 for half, or approximately half, of the liftingmotion. In other embodiments, the cartridge channel 123 and thecartridge body 142 may co-operate to support the staple 160 for lessthan half or more than half of the lifting motion. In some instances,the cartridge body 142 and the cartridge channel 123 may co-operativelysupport and/or surround the staple 160 throughout the entire liftingmotion of the staple 160.

Various embodiments described herein are described in the context oflinear end effectors and/or linear fastener cartridges. Suchembodiments, and the teachings thereof, can be applied to non-linear endeffectors and/or non-linear fastener cartridges, such as, for example,circular and/or contoured end effectors. For example, various endeffectors, including non-linear end effectors, are disclosed in U.S.patent application Ser. No. 13/036,647, filed Feb. 28, 2011, entitledSURGICAL STAPLING INSTRUMENT, now U.S. Pat. No. 8,561,870, which ishereby incorporated by reference in its entirety. Additionally, U.S.patent application Ser. No. 12/893,461, filed Sep. 29, 2010, entitledSTAPLE CARTRIDGE, now U.S. Pat. No. 8,733,613, is hereby incorporated byreference in its entirety. U.S. patent application Ser. No. 12/031,873,filed Feb. 15, 2008, entitled END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT, now U.S. Pat. No. 7,980,443, is also herebyincorporated by reference in its entirety. The entire disclosure of U.S.Pat. No. 7,845,537, entitled SURGICAL INSTRUMENT HAVING RECORDINGCAPABILITIES, which issued on Dec. 7, 2010, is incorporated by referenceherein. The entire disclosure of U.S. application Ser. No. 13/118,241,entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS, now U.S. Pat. No. 9,072,535, which was filed on May 27,2011, is incorporated by reference herein.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

Preferably, the invention described herein will be processed beforesurgery. First, a new or used instrument is obtained and if necessarycleaned. The instrument can then be sterilized. In one sterilizationtechnique, the instrument is placed in a closed and sealed container,such as a plastic or TYVEK bag. The container and instrument are thenplaced in a field of radiation that can penetrate the container, such asgamma radiation, x-rays, or high-energy electrons. The radiation killsbacteria on the instrument and in the container. The sterilizedinstrument can then be stored in the sterile container. The sealedcontainer keeps the instrument sterile until it is opened in the medicalfacility.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples. Further, this application is intended to cover suchdepartures from the present disclosure as come within known or customarypractice in the art to which this invention pertains.

What is claimed is:
 1. A surgical stapling system, comprising: an endeffector configurable in an open configuration and a closedconfiguration, comprising: an elongate channel; an anvil; a staplecartridge removably positioned in said elongate channel, wherein saidstaple cartridge comprises a plurality of staples removably storedtherein; a firing assembly movable from a starting position toward anending position during a firing stroke, wherein said staples aredeployable from said staple cartridge based on said firing assemblymoving toward said ending position, wherein said firing assemblycomprises: a first firing portion configured to maintain said endeffector in said closed configuration as said firing assembly movestoward said ending position; and a second firing portion extending fromsaid first firing portion, wherein said second firing portion comprisesa plurality of laminated strips; a motorized system configured to drivesaid firing assembly toward said ending position, wherein said motorizedsystem comprises: a motor; a gear rotatable by said motor; and a rackconfigured to longitudinally move based on rotations of said gear,wherein said rack is operably coupled to said second firing portion, andwherein said firing assembly is movable toward said ending positionbased on longitudinal movement of said rack; an elongate shaft includinga bayonet connection interface; and a handle assembly; wherein saidanvil comprises: an anvil body, comprising: a first lateral surface; asecond lateral surface; a first wall extending from said first lateralsurface; a second wall extending from said second lateral surface; afirst arc extending from said first wall; and a second arc extendingfrom said second wall; and an anvil cap welded to said anvil body,wherein said anvil cap is configured to increase a stiffness of saidanvil, wherein said anvil cap comprises a third arc, wherein said firstarc, said second arc, and said third arc cooperatively define acircumferential outer perimeter of said anvil.
 2. The surgical staplingsystem of claim 1, wherein said elongate channel comprises: an elongatechannel body; and an elongate channel cap welded to said elongatechannel body, wherein said elongate channel cap is configured toincrease a stiffness of said elongate channel.
 3. The surgical staplingsystem of claim 1, wherein said bayonet connection interface comprises abayonet receiving member configured to engage a bayonet mounting member.4. The surgical stapling system of claim 1, wherein said staplescomprise: a base comprising a substantially flat surface; and a legextending from said base.
 5. The surgical stapling system of claim 4,wherein said base defines a base plane, wherein said leg defines a legplane, and wherein said leg plane is offset said base plane.
 6. Thesurgical stapling system of claim 5, wherein said staples furthercomprise a contoured portion connecting said base to said leg, andwherein said contoured portion extends along an axis that extendsthrough said base plane and said leg plane.
 7. The surgical staplingsystem of claim 1, further comprising an articulation joint, whereinsaid end effector is rotatable relative to said elongate shaft aboutsaid articulation joint.
 8. The surgical stapling system of claim 1,wherein the anvil cap comprises an opening surface, and wherein said endeffector is configured to transition toward said open configuration,based on said firing assembly engaging said opening surface as saidfiring assembly moves toward said starting position.
 9. A surgicalfastening system, comprising: an end effector, comprising: an elongatechannel; an anvil movable relative to said elongate channel between anopen position and a closed position; a fastener cartridge removablypositioned in said elongate channel, wherein said fastener cartridgecomprises a plurality of fasteners removably stored therein; a firingassembly movable from a proximal position toward an distal positionduring a firing stroke, wherein said fasteners are deployable from saidfastener cartridge based on said firing assembly moving toward saiddistal position, wherein said firing assembly comprises: a couplingmember configured to prevent said anvil from moving to said openposition as said firing assembly moves toward said distal position; anda drive member extending from said coupling member, wherein said drivemember comprises a plurality of laminated strips; a motorized systemconfigured to drive said firing assembly toward said distal position,wherein said motorized system comprises: a motor; a gear rotatable bysaid motor; and a rack configured to longitudinally translate based onrotations of said gear, wherein said rack is operably coupled to saiddrive member, and wherein said firing assembly is movable toward saiddistal position based on longitudinal translation of said rack; anelongate shaft extending from said end effector, wherein said elongateshaft comprising a bayonet coupler; and a housing assembly, wherein saidbayonet coupler is configured to engage said housing assembly toremovably couple said elongate shaft to said housing assembly; whereinsaid anvil comprises: an anvil body; and an anvil cap welded to saidanvil body, wherein said anvil cap is configured to increase a stiffnessof said anvil.
 10. The surgical fastening system of claim 9, whereinsaid elongate channel comprises: an elongate channel body; and anelongate channel cap welded to said elongate channel body, wherein saidelongate channel cap is configured to increase a stiffness of saidelongate channel.
 11. The surgical fastening system of claim 9, whereinsaid housing assembly comprises a bayonet receiving member configured toengage said bayonet coupler to latch said elongate shaft to said housingassembly.
 12. The surgical fastening system of claim 9, wherein saidfasteners comprise: a base comprising a substantially flat surface; anda leg extending from said base.
 13. The surgical fastening system ofclaim 12, wherein said base defines a base plane, wherein said legdefines a leg plane, and wherein said leg plane is offset said baseplane.
 14. The surgical fastening system of claim 13, wherein saidfasteners further comprise a contoured portion connecting said base tosaid leg, and wherein said contoured portion extends along an axis thatextends through said base plane and said leg plane.
 15. The surgicalfastening system of claim 9, further comprising an articulation joint,wherein said end effector is rotatable relative to said elongate shaftabout said articulation joint.
 16. The surgical fastening system ofclaim 9, wherein the anvil cap comprises an opening surface, and whereinsaid anvil is configured to move toward said open position, based onsaid firing assembly engaging said opening surface as said firingassembly moves toward said proximal position.
 17. A surgical staplingsystem, comprising: an end effector, comprising: an elongate channel; ananvil, wherein said elongate channel and said anvil are configurablebetween an open configuration and a closed configuration; a staplecartridge removably positioned in said elongate channel, wherein saidstaple cartridge comprises a plurality of staples removably storedtherein; a firing assembly movable from an unfired position toward afired position during a firing stroke, wherein said staples aredeployable from said staple cartridge based on said firing assemblymoving toward said fired position, wherein said firing assemblycomprises: a head portion comprising a first flange configured to engagesaid anvil as said firing assembly moves toward said fired position anda second flange configured to engage said elongate channel as saidfiring assembly moves toward said fired position; and a tail portionextending from said head portion, wherein said tail portion comprises aplurality of laminated strips; a motorized system configured to drivesaid firing assembly toward said fired position, wherein said motorizedsystem comprises: a motor; a gear rotatable by said motor; and a rackconfigured to longitudinally move based on rotations of said gear,wherein said rack is operably coupled to said tail portion, and whereinsaid firing assembly is movable toward said fired position based onlongitudinal movement of said rack; an elongate shaft comprising abayonet mounting member; an articulation joint, wherein said endeffector is rotatable relative to said elongate shaft about saidarticulation joint; and a housing assembly, wherein said bayonetmounting member is configured to engage said housing assembly toremovably couple said elongate shaft to said housing assembly; whereinsaid anvil comprises: an anvil body; and an anvil cap welded to saidanvil body, wherein said anvil cap is configured to increase a stiffnessof said anvil.
 18. The surgical stapling system of claim 17, whereinsaid elongate channel comprises: an elongate channel body; and anelongate channel cap welded to said elongate channel body, wherein saidelongate channel cap is configured to increase a stiffness of saidelongate channel.
 19. The surgical stapling system of claim 17, whereinsaid housing assembly comprises a bayonet receiving member configured toengage said bayonet mounting member to latch said elongate shaft to saidhousing assembly.
 20. The surgical stapling system of claim 17, whereinsaid staples comprise: a base comprising a substantially flat surface;and a leg extending from said base.
 21. The surgical stapling system ofclaim 20, wherein said staples further comprise a contoured portionconnecting said base to said leg.
 22. The surgical stapling system ofclaim 17, wherein said tail portion extends through said articulationjoint.
 23. The surgical stapling system of claim 17, wherein the anvilcap comprises an opening surface, and wherein said elongate channel andsaid anvil are configured to transition toward said open configuration,based on said firing assembly engaging said opening surface as saidfiring assembly moves toward said unfired position.